Healthcare Provider Details

I. General information

NPI: 1427474410
Provider Name (Legal Business Name): TRACY MICHELLE DZUGAN MS,FNP,PMHNP-BC,APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2470 BLOOMINGDALE AVE STE 260
VALRICO FL
33596-6403
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 833-674-2500
  • Fax: 239-599-4126
Mailing address:
  • Phone: 877-856-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9364680
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9364680
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: