Provider Demographics
NPI:1376954032
Name:CAPOTE-SANCHEZ, TRACY (TRACY)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:CAPOTE-SANCHEZ
Suffix:
Gender:F
Credentials:TRACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 W 44TH PL APT 501
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7444
Mailing Address - Country:US
Mailing Address - Phone:305-794-3695
Mailing Address - Fax:
Practice Address - Street 1:9220 SUNSET DR STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3259
Practice Address - Country:US
Practice Address - Phone:305-273-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst