MEDICARE: PALM RADIATION THERAPY SERVICES PL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1922326149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALM RADIATION THERAPY SERVICES PL

Provider Business Mailing Address
First Line	:	100 BAYVIEW DR
Second Line	:	710
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-4781
Country	:	US
Telephone Number	:	860-573-8789
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 E COMMERCIAL BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4206
Country	:	US
Telephone Number	:	860-573-8789
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. ALAN MARTIN PERLMUTTER
Credential	:	M.D.
Telephone Number	:	860-573-8789

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	09/28/2010

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