Healthcare Provider Details

I. General information

NPI: 1467553040
Provider Name (Legal Business Name): DR. GENE TERREZZA,O.D. & ASSOCIATES,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N FAIRFIELD DR
PENSACOLA FL
32506-4313
US

IV. Provider business mailing address

800 N FAIRFIELD DR
PENSACOLA FL
32506-4313
US

V. Phone/Fax

Practice location:
  • Phone: 850-456-5059
  • Fax: 850-456-0461
Mailing address:
  • Phone: 850-456-5059
  • Fax: 850-456-0461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC1196
License Number StateFL

VIII. Authorized Official

Name: JENNIFER DUKES
Title or Position: BILLING MANAGER
Credential:
Phone: 850-434-2060