Individual
TRACEY BOTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
724 NW 43RD STREET, GAINESVILLE, FL 32607
(352) 332-7222
(352) 332-7330
Mailing address
724 NW 43RD ST, GAINESVILLE, FL 32607-6110
(352) 332-7222
(352) 332-7330
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME90653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272547900
—
FL
Enumeration date
02/15/2006
Last updated
12/09/2020
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