Healthcare Provider Details

I. General information

NPI: 1982921730
Provider Name (Legal Business Name): TERRI-ANN MELANIE BENNETT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N FLAMINGO RD STE 408
PEMBROKE PINES FL
33028-1012
US

IV. Provider business mailing address

2900 CORPORATE WAY # D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-3015
  • Fax: 954-276-0069
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME159261
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: