Provider Demographics
NPI:1811258239
Name:SHIPE, TRACY L (DO)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:L
Last Name:SHIPE
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:70 S DANLEY DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2437
Mailing Address - Country:US
Mailing Address - Phone:239-533-6339
Mailing Address - Fax:239-277-5017
Practice Address - Street 1:809 PINE ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6047
Practice Address - Country:US
Practice Address - Phone:352-326-5961
Practice Address - Fax:352-365-6438
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14400207ZF0201X, 207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology