Organization
MARK S. TRACY, D.P.M., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S TRACY DPM (OWNER/DOCTOR)
(941) 627-6366
Entity
Organization
Contact information
Practice address
3028 CARING WAY, STE 9, PORT CHARLOTTE, FL 33952-5300
(941) 627-6366
(941) 627-6677
Mailing address
3028 CARING WAY, STE 9, PORT CHARLOTTE, FL 33952-5300
(941) 627-6366
(941) 627-6677
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO1878
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962436030
INDIVIDUAL NPI
—
Enumeration date
04/08/2008
Last updated
08/12/2010
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