Healthcare Provider Details

I. General information

NPI: 1609169267
Provider Name (Legal Business Name): DAVID THOMAS TERRANO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9060 E VIA LINDA SUITE 150
SCOTTSDALE AZ
85258-5422
US

IV. Provider business mailing address

11025 RCA CENTER DR STE 300
PALM BEACH GARDENS FL
33410-4269
US

V. Phone/Fax

Practice location:
  • Phone: 480-275-2494
  • Fax: 480-772-4296
Mailing address:
  • Phone: 561-383-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number54161
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number54161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: