Individual
DR. TERRY-ANN S HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
ME76828
FL
208000000X
Pediatrics Physician
ME0076828
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256042900
—
FL
01
—
46501
BLUE SHIELD
FL
Enumeration date
06/15/2006
Last updated
03/22/2021
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