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NPI Code Detail

MEDICARE: TRACY FIELDS JR.

MEDICARE:   TRACY  FIELDS JR.
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1427911163
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY FIELDS JR.
Provider Business Mailing Address
First Line : 1621 BAY RD APT 901
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-3260
Country : US
Telephone Number : 574-274-1952
Fax Number :
Provider Business Practice Location Address
First Line : 1621 BAY RD APT 901
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33139-3260
Country : US
Telephone Number : 574-274-1952
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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