Provider Demographics
NPI:1780721837
Name:TERZIAN, NELSON A (MD)
Entity type:Individual
Prefix:DR
First Name:NELSON
Middle Name:A
Last Name:TERZIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 OCEAN DR
Mailing Address - Street 2:UNIT 902
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-4133
Mailing Address - Country:US
Mailing Address - Phone:305-695-0805
Mailing Address - Fax:
Practice Address - Street 1:91550 OVERSEAS HWY
Practice Address - Street 2:SUIT 104
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2506
Practice Address - Country:US
Practice Address - Phone:305-853-7165
Practice Address - Fax:305-853-7166
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 474312088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD69020Medicare UPIN
FL03893Medicare ID - Type Unspecified