Provider Demographics
NPI:1285677765
Name:HOPKINS, TERRENCE T (M D)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:T
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2709
Mailing Address - Country:US
Mailing Address - Phone:941-792-5040
Mailing Address - Fax:941-792-5026
Practice Address - Street 1:6011 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2709
Practice Address - Country:US
Practice Address - Phone:941-792-5040
Practice Address - Fax:941-792-5026
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 68372174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27579XMedicare ID - Type UnspecifiedINDIVIDUAL
FLK1610Medicare ID - Type UnspecifiedGROUP
FLF91409Medicare UPIN