MEDICARE: TRACIE GARI APRN-C

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	363LA2200X	Adult Health Nurse Practitioner	616997	TX
2	363LA2200X	Adult Health Nurse Practitioner	ARNP2977622	FL
3	363LA2200X	Adult Health Nurse Practitioner	APRN2977622	FL

General Provider Information

NPI Number	:	1659315190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACIE GARI APRN-C

Provider Business Mailing Address
First Line	:	504 N REO ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1013
Country	:	US
Telephone Number	:	813-549-2134
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 N HABANA AVE STE 300
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7148
Country	:	US
Telephone Number	:	833-446-7481
Fax Number	:	813-569-1759

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/23/2021

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