Organization
ALTAMONTE OB GYN ASSOC CLARK & PERLSTEIN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ELLIOT CLARK M.D. (PRESIDENT)
(407) 339-9500
Entity
Organization
Contact information
Practice address
475 OSCEOLA ST, SUITE 1200, ALTAMONTE SPRINGS, FL 32701-7857
(407) 339-9500
(407) 339-2266
Mailing address
475 OSCEOLA ST, SUITE 1200, ALTAMONTE SPRINGS, FL 32701-7857
(407) 339-9500
(407) 339-2266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
69-01-025691-82
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39993
MEDICARE PTAN, BCBS PIN
FL
Enumeration date
07/28/2010
Last updated
05/18/2012
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