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Organization
RUSSELL E. PERRY, M.D., P.A.
Active
Organization
RUSSELL E. PERRY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANN PERRY (OFFICE MANAGER)
(386) 423-1212
Entity
Organization
Contact information
Practice address
406 PALMETTO ST STE A, NEW SMYRNA BEACH, FL 32168-7323
(386) 423-1212
(386) 423-5730
Mailing address
406 PALMETTO ST STE A, NEW SMYRNA BEACH, FL 32168-7323
(386) 423-1212
(386) 423-5730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64384
BCBS
FL
Enumeration date
10/02/2007
Last updated
01/28/2010
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