Provider Demographics
NPI:1578601654
Name:UNIVERSITY OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:UNIVERSITY OF SOUTH FLORIDA
Other - Org Name:STUDENT HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EGILDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TERENZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-974-2331
Mailing Address - Street 1:4202 E FOWLER AVE
Mailing Address - Street 2:SHS100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33620-6750
Mailing Address - Country:US
Mailing Address - Phone:813-974-2331
Mailing Address - Fax:813-974-8391
Practice Address - Street 1:4202 E FOWLER AVE
Practice Address - Street 2:SHS100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33620-6750
Practice Address - Country:US
Practice Address - Phone:813-974-2331
Practice Address - Fax:813-974-8391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health