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NPI Code Detail

MEDICARE: DR. TRACY L BURNEY M.D.

MEDICARE: DR. TRACY L BURNEY M.D.
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
1174400000XSpecialistME0070713FL
2208800000XUrology PhysicianME70713FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
131225UOTHERFLMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1982795985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACY L BURNEY M.D.
Provider Business Mailing Address
First Line : 3300 S FISKE BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-4306
Country : US
Telephone Number : 321-434-4600
Fax Number : 321-951-7408
Provider Business Practice Location Address
First Line : 1026 PATHFINDER WAY
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-3216
Country : US
Telephone Number : 321-631-2070
Fax Number : 321-631-6489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 05/01/2018

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