Provider Demographics
NPI:1518046713
Name:PEROVICH, ROBERT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:PEROVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MS
Other - First Name:JACQUIE
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9080 KIMBERLY BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2862
Mailing Address - Country:US
Mailing Address - Phone:954-346-9404
Mailing Address - Fax:954-344-8460
Practice Address - Street 1:9080 KIMBERLY BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2862
Practice Address - Country:US
Practice Address - Phone:954-346-9404
Practice Address - Fax:954-344-8460
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME640162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL189982Medicare ID - Type Unspecified
E40739Medicare UPIN