MEDICARE: DR. CURNEISHA BRYANT TERRY AU.D.

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	231H00000X	Audiologist	AY 1428	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AY1428	OTHER	FL	FLORIDA STATE LICENSURE

General Provider Information

NPI Number	:	1609066919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CURNEISHA BRYANT TERRY AU.D.

Provider Business Mailing Address
First Line	:	7305 N. MILITARY TRAIL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-9042
Country	:	US
Telephone Number	:	561-442-6974
Fax Number	:

Provider Business Practice Location Address
First Line	:	7305 N. MILITARY TRAIL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-9042
Country	:	US
Telephone Number	:	561-442-6974
Fax Number	:

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

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	11/29/2010

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