Healthcare Provider Details

I. General information

NPI: 1861712077
Provider Name (Legal Business Name): JOSE LUIS TERRAZAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 N STATE ROAD 7 STE 204
MARGATE FL
33063-5737
US

IV. Provider business mailing address

2825 N STATE ROAD 7 STE 204
MARGATE FL
33063-5737
US

V. Phone/Fax

Practice location:
  • Phone: 954-341-8288
  • Fax: 954-341-5165
Mailing address:
  • Phone: 954-341-8288
  • Fax: 954-341-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME119774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: