Individual
TRACEY LYNN NIMEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
602 S HOWARD AVE, TAMPA, FL 33606-2413
(813) 253-2406
(813) 257-4290
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003142600
—
FL
01
—
P01600606
RR MCR
FL
Enumeration date
01/09/2007
Last updated
03/22/2016
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