Provider Demographics
NPI:1568432573
Name:TRACY, JAMES F (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:TRACY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10860 SW 88TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2680
Mailing Address - Country:US
Mailing Address - Phone:305-552-5545
Mailing Address - Fax:305-552-0156
Practice Address - Street 1:10860 SW 88 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-552-5545
Practice Address - Fax:305-552-0156
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2268213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390081900Medicaid
FLPO2268OtherSTATE LICENCE
FLPO2268OtherSTATE LICENCE
FLU40787Medicare UPIN
FL390081900Medicaid