Healthcare Provider Details

I. General information

NPI: 1558860445
Provider Name (Legal Business Name): BELL & TERREZZA O.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N FAIRFIELD DR
PENSACOLA FL
32506-4313
US

IV. Provider business mailing address

113 PALAFOX PLACE
PENSACOLA FL
32502
US

V. Phone/Fax

Practice location:
  • Phone: 850-456-5059
  • Fax: 850-456-0461
Mailing address:
  • Phone: 850-434-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

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