Individual
PETER PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1409 KINGSLEY AVE, SUITE 6A, ORANGE PARK, FL 32073-4537
(904) 264-7517
(904) 264-0015
Mailing address
7855 ARGYLE FOREST BLVD., STE. 101, JACKSONVILLE, FL 32244-5597
(904) 282-6331
(904) 282-4117
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103649
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293082000
—
FL
Enumeration date
04/05/2006
Last updated
08/07/2017
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