MEDICARE: TRACY S FLOYD MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW9595	FL

General Provider Information

NPI Number	:	1699939264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY S FLOYD MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1031
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32170-1031
Country	:	US
Telephone Number	:	386-690-9585
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 C ST
Second Line	:
City	:	ST AUGUSTINE BEACH
State	:	FL
Zip	:	32080-7184
Country	:	US
Telephone Number	:	386-690-9585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	10/01/2024

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