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NPI Code Detail

MEDICARE: DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC

MEDICARE: DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1396060083
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC
Provider Business Mailing Address
First Line : 1815 E FOWLER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5525
Country : US
Telephone Number : 813-979-2929
Fax Number : 813-979-9479
Provider Business Practice Location Address
First Line : 800 N FAIRFIELD DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32506-4313
Country : US
Telephone Number : 850-456-5059
Fax Number : 850-456-0461
Authorized Official
Title or Position : INSURANCE MANAGER
Name : JENNIFER J DUKES
Credential :
Telephone Number : 850-456-5059
Provider Enumeration Date : 04/06/2010
Last Update Date : 04/06/2010

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Directions to “DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC ” Practice Location

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