Provider Demographics
NPI:1265419220
Name:PERLMUTTER, JERRY MARTIN (DPM)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:MARTIN
Last Name:PERLMUTTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6341 NW 57TH WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4409
Mailing Address - Country:US
Mailing Address - Phone:954-345-9492
Mailing Address - Fax:954-972-4498
Practice Address - Street 1:5800 COLONIAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5682
Practice Address - Country:US
Practice Address - Phone:954-974-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1173213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist