Healthcare Provider Details

I. General information

NPI: 1013774124
Provider Name (Legal Business Name): TONI TRAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7609 S ORANGE BLOSSOM TRL
ORLANDO FL
32809-6903
US

IV. Provider business mailing address

851 BROKEN SOUND PKWY NW STE 120
BOCA RATON FL
33487-3638
US

V. Phone/Fax

Practice location:
  • Phone: 407-859-7005
  • Fax:
Mailing address:
  • Phone: 561-367-1623
  • Fax: 561-299-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: