Healthcare Provider Details

I. General information

NPI: 1841592953
Provider Name (Legal Business Name): TERRI-ANN GLISPIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 S ORANGE AVE STE 103
ORLANDO FL
32806-1200
US

IV. Provider business mailing address

1118 S ORANGE AVE STE 103
ORLANDO FL
32806-1200
US

V. Phone/Fax

Practice location:
  • Phone: 407-897-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.017052
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA70
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS20871
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: