Provider Demographics
NPI:1306836317
Name:PEPPY, TERRENCE S (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:S
Last Name:PEPPY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7243 DELLA DR FL 2
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5104
Mailing Address - Country:US
Mailing Address - Phone:407-381-7336
Mailing Address - Fax:321-203-4646
Practice Address - Street 1:7243 DELLA DR FL 2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5104
Practice Address - Country:US
Practice Address - Phone:407-381-7336
Practice Address - Fax:321-203-4646
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68150207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379947600Medicaid
G12289Medicare UPIN
FL379947600Medicaid