MEDICARE: TRACY LYNN CHIRINO DMD

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	1223G0001X	General Practice Dentistry	DN17473	FL

General Provider Information

NPI Number	:	1952450165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY LYNN CHIRINO DMD

Provider Business Mailing Address
First Line	:	13351 SW 46TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3916
Country	:	US
Telephone Number	:	305-229-3034
Fax Number	:

Provider Business Practice Location Address
First Line	:	9230 SW 40TH ST
Second Line	:	SUITE A
City	:	MIAMI
State	:	FL
Zip	:	33165-4166
Country	:	US
Telephone Number	:	305-221-2334
Fax Number	:	305-221-2335

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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