Gary Eugene Perigo, L.M.T.
Individual provider Active NPI Specialist · Sorrento, FL
NPI 1366614596 · NPPES record last updated Mar 27, 2008
Key facts
- NPI
- 1366614596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA14071 (FL)
- Practice address
- 34001 Terragona Dr
Sorrento, FL 32776-6926 - Phone
- (321) 356-6544
- NPI assigned
- Mar 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA14071 | FL | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA14071 | FL | Yes |
Addresses
Primary practice location
34001 Terragona Dr
Sorrento, FL 32776-6926
Mailing address
34001 Terragona Dr
Sorrento, FL 32776-6926
Phone (321) 356-6544
Other providers in Sorrento, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.