Provider Demographics
NPI:1376106583
Name:XOUSIA-KROSS TRAQ CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:XOUSIA-KROSS TRAQ CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN-BC
Authorized Official - Phone:954-559-1010
Mailing Address - Street 1:PO BOX 260786
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-7786
Mailing Address - Country:US
Mailing Address - Phone:954-559-1010
Mailing Address - Fax:
Practice Address - Street 1:6616 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-4920
Practice Address - Country:US
Practice Address - Phone:954-559-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty