Healthcare Provider Details

I. General information

NPI: 1376954032
Provider Name (Legal Business Name): TRACY CAPOTE-SANCHEZ TRACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 SUNSET DR STE 101
MIAMI FL
33173-3259
US

IV. Provider business mailing address

1825 W 44TH PL APT 501
HIALEAH FL
33012-7444
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-3773
  • Fax:
Mailing address:
  • Phone: 305-794-3695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: