MEDICARE: ARIEL NICOLE BRACEY

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
1	1041C0700X	Clinical Social Worker	SW17931

General Provider Information

NPI Number	:	1356838791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL NICOLE BRACEY

Provider Business Mailing Address
First Line	:	1971 W LUMSDEN RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1612 DOGWOOD FLOWER LN APT 102
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6883
Country	:	US
Telephone Number	:	813-812-9568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2018
Last Update Date	:	01/13/2025

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Directions to “ ARIEL NICOLE BRACEY ” Practice Location

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