Healthcare Provider Details

I. General information

NPI: 1740341544
Provider Name (Legal Business Name): TRACY J ROBERTS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N 9TH AVE PEDIATRIC OFFICE BUILDING
PENSACOLA FL
32504-8785
US

IV. Provider business mailing address

PO BOX 2699 SHMG/HPE
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-1575
  • Fax: 850-416-1302
Mailing address:
  • Phone: 850-416-1575
  • Fax: 850-416-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberTRN6923
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number300814
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME104897
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberME104897
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: