Provider Demographics
NPI:1902975477
Name:PERLA D INACAY MD PA
Entity Type:Organization
Organization Name:PERLA D INACAY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PERLA
Authorized Official - Middle Name:DEVEZA
Authorized Official - Last Name:INACAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-231-6204
Mailing Address - Street 1:701 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-3100
Mailing Address - Country:US
Mailing Address - Phone:813-231-6204
Mailing Address - Fax:813-231-7110
Practice Address - Street 1:701 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE 2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3100
Practice Address - Country:US
Practice Address - Phone:813-231-6204
Practice Address - Fax:813-231-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60315207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6008Medicare PIN
FLDE1205Medicare PIN