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General NPI Number Information
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NPI Number | 1891721197
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Entity Type | Individual
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Provider Name | TRACY G. SANSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 2 COLUMBIA DR
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City | TAMPA
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State | FL
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Zip | 33606-3508
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Country | US
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Telephone | 813-844-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 14050 NW 14TH ST SUITE 190
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City | SUNRISE
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State | FL
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Zip | 33323-2865
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Country | US
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Telephone | 800-424-3672
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Fax | 954-377-3042
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-16690
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 12948102-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 113032
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME68990
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License Number State | FL
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