Provider Demographics
NPI:1659315190
Name:GARI, TRACIE (APRN-C)
Entity Type:Individual
Prefix:
First Name:TRACIE
Middle Name:
Last Name:GARI
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N REO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1013
Mailing Address - Country:US
Mailing Address - Phone:813-549-2134
Mailing Address - Fax:
Practice Address - Street 1:4730 N HABANA AVE STE 300
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7148
Practice Address - Country:US
Practice Address - Phone:833-446-7481
Practice Address - Fax:813-569-1759
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX616997363LA2200X
FLARNP2977622363LA2200X
FLAPRN2977622363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health