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Individual

MARK L PERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2107 SE OCEAN BLVD, STUART, FL 34996-3305
(772) 403-2390
(772) 403-2395
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
FLME59298
FL
2085R0001X
Radiation Oncology Physician
Primary
ME59298
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11781
BCBS
FL
01
1249231
WELLCARE
FL
01
1613633
CIGNA
FL
01
278876
AVMED
FL
05
374538400
FL
01
4335023
AETNA
FL
01
P01572583
RR MEDICARE
FL
01
P106954
FREEDOM
FL
01
P938826
OPTIMUM
FL
Enumeration date
12/13/2005
Last updated
10/20/2016
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