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General NPI Number Information
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NPI Number | 1164572806
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Entity Type | Individual
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Provider Name | TRACY S FANSLER MD LLC M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 11200 SEMINOLE BLVD STE 203
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City | SEMINOLE
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State | FL
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Zip | 33778-3239
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Country | US
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Telephone | 727-306-2525
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Fax | 727-202-8196
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Provider Business Mailing Address
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Address Line | PO BOX 9100
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City | BELFAST
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State | ME
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Zip | 04915-9100
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Country | US
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Telephone | 561-300-2410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME68721
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License Number State | FL
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