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Organization
TRACY S FANSLER MD LLC
Active
Organization
TRACY S FANSLER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY S FANSLER M.D. (PRESIDENT)
(727) 584-9500
Entity
Organization
Contact information
Practice address
12955 SEMINOLE BLVD, LARGO, FL 33778-2399
(727) 584-9500
(727) 584-9502
Mailing address
11200 SEMINOLE BLVD STE 210, LARGO, FL 33778-3239
(727) 584-9500
(727) 440-9178
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261667000
—
FL
Enumeration date
09/14/2007
Last updated
01/14/2019
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