Provider Demographics
NPI:1992783385
Name:TERENCE PEPPARD, M.D.,P.A.
Entity type:Organization
Organization Name:TERENCE PEPPARD, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-652-7134
Mailing Address - Street 1:4350 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2934
Mailing Address - Country:US
Mailing Address - Phone:305-652-7134
Mailing Address - Fax:305-677-3126
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:KOHLY CENTER AT MERCY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-652-7134
Practice Address - Fax:305-677-3126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376722100Medicaid