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NPI Code Detail

MEDICARE: DR. MATTHEW ALAN TRACEY D.O.M., A.P.

MEDICARE:  DR. MATTHEW ALAN TRACEY  D.O.M., A.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAP953FL

General Provider Information

NPI Number : 1174709612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW ALAN TRACEY D.O.M., A.P.
Provider Business Mailing Address
First Line : 3325 GRIFFIN RD STE E176
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33312-5500
Country : US
Telephone Number : 954-394-9098
Fax Number : 954-688-2526
Provider Business Practice Location Address
First Line : 3325 GRIFFIN RD STE E176
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33312-5500
Country : US
Telephone Number : 954-797-8688
Fax Number : 954-688-2526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2008
Last Update Date : 03/22/2010

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Directions to “ DR. MATTHEW ALAN TRACEY D.O.M., A.P.” Practice Location

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