Healthcare Provider Details

I. General information

NPI: 1891250106
Provider Name (Legal Business Name): TERENCE MCADOO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 HULSE RD
PENSACOLA FL
32508-1089
US

IV. Provider business mailing address

340 HULSE RD
PENSACOLA FL
32508-1089
US

V. Phone/Fax

Practice location:
  • Phone: 850-452-9484
  • Fax:
Mailing address:
  • Phone: 850-452-9484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: