MEDICARE: BAPTIST TERREZZA GROUP OD PA

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1659196293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST TERREZZA GROUP OD PA

Provider Business Mailing Address
First Line	:	113 PALAFOX PL
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32502-5629
Country	:	US
Telephone Number	:	850-434-2060
Fax Number	:	850-429-8215

Provider Business Practice Location Address
First Line	:	121 BAPTIST WAY STE 12001300
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-2254
Country	:	US
Telephone Number	:	850-407-9474
Fax Number	:	850-407-9724

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	JENNIFER DUKES
Credential	:
Telephone Number	:	850-434-2060

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	06/25/2026

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