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Individual
MR. SAMUEL PERENICH
Active
Individual
MR. SAMUEL PERENICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9119155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA067383
LICENSE
PA
01
—
PA9119155
STATE LICENSE
FL
Enumeration date
10/02/2024
Last updated
12/03/2025
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