Individual
DR. MARK E TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-2578
Mailing address
2718 N ORANGE AVE, SUITE C, ORLANDO, FL 32804-7611
(407) 303-2578
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036-109303
IL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME113742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-109303-1
—
IL
Enumeration date
08/15/2005
Last updated
08/22/2012
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