Provider Demographics
NPI:1932165099
Name:MCENDREE, TERRI L (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:MCENDREE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 HEALING WAY STE 305
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5453
Mailing Address - Country:US
Mailing Address - Phone:813-929-5341
Mailing Address - Fax:813-929-5393
Practice Address - Street 1:2700 HEALING WAY STE 305
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5453
Practice Address - Country:US
Practice Address - Phone:813-929-5341
Practice Address - Fax:813-929-5393
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87789207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267698200Medicaid
FL79246OtherBCBS
FL79246OtherBCBS
FL79246ZMedicare PIN
FL79246XMedicare PIN