MEDICARE: TERRI L MCENDREE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME87789	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	79246	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1932165099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI L MCENDREE MD

Provider Business Mailing Address
First Line	:	2700 HEALING WAY STE 305
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5453
Country	:	US
Telephone Number	:	813-929-5341
Fax Number	:	813-929-5393

Provider Business Practice Location Address
First Line	:	2700 HEALING WAY STE 305
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5453
Country	:	US
Telephone Number	:	813-929-5341
Fax Number	:	813-929-5393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	11/10/2017

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