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General NPI Number Information
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NPI Number | 1811258239
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Entity Type | Individual
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Provider Name | TRACY L SHIPE D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2012
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 809 PINE ST
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City | LEESBURG
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State | FL
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Zip | 34748-6047
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Country | US
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Telephone | 352-326-5961
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Fax | 352-365-6438
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Provider Business Mailing Address
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Address Line | 70 S DANLEY DR
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City | FORT MYERS
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State | FL
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Zip | 33907-2437
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Country | US
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Telephone | 239-533-6339
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Fax | 239-277-5017
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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 | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | OS14400
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License Number State | FL
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