Individual
KRISTIN JOAN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME137522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111643200
—
FL
01
—
LGJQ5
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/28/2017
Last updated
01/23/2023
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