Provider Demographics
NPI:1598708430
Name:VO, TRACY (DO)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12730 NEW BRITTANY BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4690
Mailing Address - Country:US
Mailing Address - Phone:239-275-5522
Mailing Address - Fax:239-275-4464
Practice Address - Street 1:1708 CAPE CORAL PKWY W
Practice Address - Street 2:#4
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6985
Practice Address - Country:US
Practice Address - Phone:239-945-5940
Practice Address - Fax:239-945-5941
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49598OtherFLORIDA BLUE
FL010578100Medicaid
FL49598OtherFLORIDA BLUE
H01574Medicare UPIN
110244711Medicare PIN