Provider Demographics
NPI:1164772687
Name:DAVID L. TERZIGNI, P.A.
Entity Type:Organization
Organization Name:DAVID L. TERZIGNI, P.A.
Other - Org Name:BAYSIDE FAMILY MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:TERZIGNI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-597-0050
Mailing Address - Street 1:5355 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4540
Mailing Address - Country:US
Mailing Address - Phone:352-688-5586
Mailing Address - Fax:352-688-5535
Practice Address - Street 1:5355 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4540
Practice Address - Country:US
Practice Address - Phone:352-688-5586
Practice Address - Fax:352-688-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261770600Medicaid
H45871Medicare UPIN