Provider Demographics
NPI:1205902061
Name:SOLLITTO, TRACY LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:SOLLITTO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1656 MEDICAL BLVD
Mailing Address - Street 2:STE. 302
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1423
Mailing Address - Country:US
Mailing Address - Phone:239-200-7981
Mailing Address - Fax:239-513-7923
Practice Address - Street 1:1656 MEDICAL BLVD
Practice Address - Street 2:STE. 302
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1423
Practice Address - Country:US
Practice Address - Phone:239-200-7981
Practice Address - Fax:239-513-7923
Is Sole Proprietor?:No
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9204630363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner