Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 45819 | MN |
Y | 208800000X | Urologist | ME97146 | FL |
NPI | 1013996859 |
---|---|
Provider Name | Matthew J Perry |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Sarasota, FL 34237-6014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 18/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003884800 | (05) | FL |
0262533 | CIGNA (01) | FL |
124774 | UNIVERSAL (01) | FL |
305536 | AVMED (01) | FL |
7500847 | AETNA (01) | FL |
974698600 | (05) | MN |
H57745 | (02) | |
P01051886 | RAILROAD MCR (01) | FL |
P01807671 | CLEAR HEALTH (01) | FL |
P105219 | FREEDOM HEALTH (01) | FL |
P302195 | OPTIMUM (01) | FL |