Individual
LISA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 41ST STREET OCEAN, MARATHON, FL 33050-2373
(305) 434-7660
Mailing address
720 62ND STREET OCEAN, MARATHON, FL 33050-2739
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2730022
FL
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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