MEDICARE: MS. ANELLE SOFIA TERRELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9119673	FL
2	363A00000X	Physician Assistant	PA9113377
3	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205451465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANELLE SOFIA TERRELL

Provider Business Mailing Address
First Line	:	3880 BIRD RD APT 832
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33146-1547
Country	:	US
Telephone Number	:	352-359-7143
Fax Number	:

Provider Business Practice Location Address
First Line	:	9155 S DADELAND BLVD PH 1
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33156-2737
Country	:	US
Telephone Number	:	305-670-9995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2020
Last Update Date	:	09/18/2025

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