Healthcare Provider Details

I. General information

NPI: 1740483403
Provider Name (Legal Business Name): CEDRIC ARTIMIS TERRELL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14454 CHERRY LAKE DR W
JACKSONVILLE FL
32258-5138
US

IV. Provider business mailing address

14454 CHERRY LAKE DR W
JACKSONVILLE FL
32258-5138
US

V. Phone/Fax

Practice location:
  • Phone: 904-880-9375
  • Fax: 904-683-8770
Mailing address:
  • Phone: 904-880-9375
  • Fax: 904-683-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS35127
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberPU6125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: