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General NPI Number Information
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NPI Number | 1235309857
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Entity Type | Organization
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Legal Business Name | TERRERO MEDICAL CENTER LLC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 12651 W SUNRISE BLVD
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-514-0995
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Fax | 954-514-0994
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Provider Business Mailing Address
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Address Line | 12651 W SUNRISE BLVD
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City | SUNRISE
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State | FL
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Zip | 33323-0906
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Country | US
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Telephone | 954-514-0995
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Fax | 954-514-0994
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Authorized Official
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Title or Position | MD
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Name | ALFREDO TERRERO-FERNANDEZ
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Credential | MD
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Telephone | 954-838-7543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 95311
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License Number State | FL
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