=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679677207
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PETER PEARLMAN, MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2006
-----------------------------------------------------
Last Update Date | 02/13/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5258 LINTON BLVD SUITE 204
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-495-0808
-----------------------------------------------------
Fax | 561-499-1704
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5258 LINTON BLVD SUITE 204
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6540
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-495-0808
-----------------------------------------------------
Fax | 561-499-1704
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | PETER MARTIN PEARLMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 561-495-0808
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | ME39217
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------