Healthcare Provider Details

I. General information

NPI: 1891603494
Provider Name (Legal Business Name): MR. TRACY AARONS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508B LAKE AVE
LAKE WORTH BEACH FL
33460-3809
US

IV. Provider business mailing address

508B LAKE AVE
LAKE WORTH BEACH FL
33460-3809
US

V. Phone/Fax

Practice location:
  • Phone: 561-946-2020
  • Fax:
Mailing address:
  • Phone: 561-946-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number27-00074189
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: