Healthcare Provider Details

I. General information

NPI: 1306836317
Provider Name (Legal Business Name): TERRENCE S. PEPPY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 DELLA DR FL 2
ORLANDO FL
32819-5104
US

IV. Provider business mailing address

7243 DELLA DR FL 2
ORLANDO FL
32819-5104
US

V. Phone/Fax

Practice location:
  • Phone: 407-381-7336
  • Fax: 321-203-4646
Mailing address:
  • Phone: 407-381-7336
  • Fax: 321-203-4646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME68150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: