Provider Demographics
NPI:1871515338
Name:PEARLMAN, GWEN (DO)
Entity type:Individual
Prefix:
First Name:GWEN
Middle Name:
Last Name:PEARLMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8903 GLADES RD
Mailing Address - Street 2:SUITE K-1A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4074
Mailing Address - Country:US
Mailing Address - Phone:561-955-6111
Mailing Address - Fax:561-955-6122
Practice Address - Street 1:8903 GLADES RD
Practice Address - Street 2:SUITE K-1A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4074
Practice Address - Country:US
Practice Address - Phone:561-955-6111
Practice Address - Fax:561-955-6122
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9793207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBP9839448OtherDEA