Provider Demographics
NPI:1396060083
Name:DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC
Entity type:Organization
Organization Name:DRS CARLSON, HOLLIS, & TERREZZA AND ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-456-5059
Mailing Address - Street 1:1815 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5525
Mailing Address - Country:US
Mailing Address - Phone:813-979-2929
Mailing Address - Fax:813-979-9479
Practice Address - Street 1:800 N FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-4313
Practice Address - Country:US
Practice Address - Phone:850-456-5059
Practice Address - Fax:850-456-0461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty