Provider Demographics
NPI:1952450165
Name:CHIRINO, TRACY LYNN (DMD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:CHIRINO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13351 SW 46TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3916
Mailing Address - Country:US
Mailing Address - Phone:305-229-3034
Mailing Address - Fax:
Practice Address - Street 1:9230 SW 40TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4166
Practice Address - Country:US
Practice Address - Phone:305-221-2334
Practice Address - Fax:305-221-2335
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN174731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice