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General NPI Number Information
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NPI Number | 1487530010
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Entity Type | Individual
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Provider Name | TRACY LYNN WORLUND
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 4427 EMERSON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32207-4969
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Country | US
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Telephone | 904-398-7015
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Fax |
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Provider Business Mailing Address
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Address Line | 13253 MORNING SUN DR
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City | JACKSONVILLE
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State | FL
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Zip | 32225-3175
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Country | US
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Telephone | 860-716-2016
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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 | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 2083A0300X
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License Number State | FL
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