Individual
DR. TERESA C TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1717 S ORANGE AVE, SUITE 100, ORLANDO, FL 32806-2944
(407) 650-7000
(407) 650-7124
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600541100
—
FL
Enumeration date
08/29/2006
Last updated
09/03/2011
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