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General NPI Number Information
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NPI Number | 1629597174
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Entity Type | Individual
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Provider Name | MARTIN LEWIS PERCHER LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 450 N PARK RD STE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6918
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Country | US
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Telephone | 954-925-3191
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Fax | 954-925-3193
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Provider Business Mailing Address
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Address Line | 3265 NW 47TH AVE # 3211
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City | COCONUT CREEK
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State | FL
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Zip | 33063-1803
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Country | US
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Telephone | 954-732-0440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW3624
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License Number State | FL
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