Provider Demographics
NPI:1275358814
Name:NAVARRE TERREZZA OPTICAL GROUP, O.D., P.A.
Entity type:Organization
Organization Name:NAVARRE TERREZZA OPTICAL GROUP, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-434-2060
Mailing Address - Street 1:113 PALAFOX PL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5629
Mailing Address - Country:US
Mailing Address - Phone:850-434-2060
Mailing Address - Fax:850-429-8215
Practice Address - Street 1:7515 HARVEST VILLAGE CT
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7320
Practice Address - Country:US
Practice Address - Phone:850-407-5996
Practice Address - Fax:850-407-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty