Provider Demographics
NPI:1730147026
Name:PERKINS, LILY PAN (DPM)
Entity type:Individual
Prefix:DR
First Name:LILY
Middle Name:PAN
Last Name:PERKINS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:221 GREENWICH CIRCLE
Mailing Address - Street 2:SUITE 221
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-799-9581
Mailing Address - Fax:561-799-0062
Practice Address - Street 1:221 GREENWICH CIRCLE
Practice Address - Street 2:SUITE 221
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-799-9581
Practice Address - Fax:561-799-0062
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO2994213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340292400Medicaid
FL340292400Medicaid
FL65791AMedicare ID - Type Unspecified