Provider Demographics
NPI:1619904083
Name:VOTANO, TRACEY J (CRNA)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:J
Last Name:VOTANO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 SW 37TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2754
Mailing Address - Country:US
Mailing Address - Phone:305-461-3229
Mailing Address - Fax:305-461-3288
Practice Address - Street 1:2645 SW 37TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2754
Practice Address - Country:US
Practice Address - Phone:305-461-3229
Practice Address - Fax:305-461-3288
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9202077367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306198100Medicaid
FL306198100Medicaid