Individual
TERRANCE T. URSETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1779 N UNIVERSITY DR, SUITE #101, PEMBROKE PINES, FL 33024-0929
(954) 963-0888
Mailing address
4631 NW 31ST AVE, SUITE 127, FORT LAUDERDALE, FL 33309-3433
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS5848
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064549400
—
FL
01
—
80410
B/S FL
FL
01
—
80410W
MEDICARE
FL
01
—
P01051387
RR MEDICARE
FL
Enumeration date
03/06/2006
Last updated
07/04/2016
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