Doctor Name: | JACQUELYN S PERRY |
NPI Number: | 1457512790 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 0116018730 |
Business Practice Address: | 3601 Sw 160th Ave Suite 250 Miramar, FL - 330276308 |
Business Phone Number: | 8778667123 |
Business Fax Number: | |
Mailing Address: | 110 Gables Dr, BIRMINGHAM |
State: | AL |
Postal Code: | 352441848 |
Phone Number: | 2059140107 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2008 |
NPI Last Update Date: | 05/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0116018730 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |