| Doctor Name: | DR. MARK NICHOLAS PERENICH |
| NPI Number: | 1497060487 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | UO2392 |
| Business Practice Address: | 2025 Indian Rocks Rd Largo, FL - 33774 |
| Business Phone Number: | 7275867103 |
| Business Fax Number: | 7275857205 |
| Mailing Address: | 2550 Bryan Ln, TARPON SPRINGS |
| State: | FL |
| Postal Code: | 346887345 |
| Phone Number: | 2154906952 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2010 |
| NPI Last Update Date: | 04/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | UO2392 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |