MEDICARE: TRACI VIAU ARNP

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	363LP0200X	Pediatric Nurse Practitioner	APRN9265648	FL
2	363L00000X	Nurse Practitioner	ARNP9265648	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528200284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACI VIAU ARNP

Provider Business Mailing Address
First Line	:	PO BOX 918025
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-8025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3227 S HORSESHOE DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-6114
Country	:	US
Telephone Number	:	239-449-9882
Fax Number	:	239-449-9884

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

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	12/04/2024

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Directions to “ TRACI VIAU ARNP” Practice Location

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