Provider Demographics
NPI:1407823537
Name:TERZIGNI, DOUGLAS E (DO)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:E
Last Name:TERZIGNI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3120
Mailing Address - Country:US
Mailing Address - Phone:727-584-7706
Mailing Address - Fax:727-585-5997
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-584-7706
Practice Address - Fax:727-585-5997
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS62142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1420847OtherUNITED
FL209396OtherAVMED
FL1074937OtherCAREPLUS
FL5811031OtherAETNA
FL6313183OtherCIGNA
FL80561OtherBCBS
FLP00765721OtherRAILROAD MEDICARE
FL057314100Medicaid
FL80561OtherBCBS
FLP00765721OtherRAILROAD MEDICARE