Tracey Amanda Bleau in Orange Park - Medical
Tracey Amanda Bleau - NPI 1215023775
Tracey Amanda Bleau is a Medical in Orange Park, Florida. Tracey Amanda Bleau practices all healthcare services and medical treatments related to Medical. The NPI Number for Tracey Amanda Bleau is 1215023775. The last update date is 2010-07-20.
Tracey Amanda Bleau's current location address is 2021 Kingsley Ave, Orange Park, Florida. You can contact this provider via phone number 9042982113 and fax number 9042982113. The mailing address for Tracey Amanda Bleau is 2021 Kingsley Ave, Orange Park, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracey Amanda Bleau |
|---|---|
| Address | 2021 Kingsley Ave, Orange Park, Florida |
| Phone Number | 9042982113 |
| Fax Number | 9042982113 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1215023775 |
|---|---|
| Provider Enumeration Date | 2006-10-04 |
| Last Updated Date | 2010-07-20 |
Provider Mailing Address Detail
| Address | 2021 Kingsley Ave |
|---|---|
| City | Orange Park |
| State | Florida (FL) |
| Post Code | 320735174 |
| Phone Number | 9042982113 |
| Fax Number | 9042982113 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA 910322 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 258902800 | FL | -- |
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What is the unique 10-digit identifier code issued to Tracey Amanda Bleau by the Centers for Medicare & Medicaid Services?
The Tracey Amanda Bleau has been assigned the NPI (National Provider Identifier) 1215023775 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Tracey Amanda Bleau's facilities are situated?
The facilities of Tracey Amanda Bleau are physically located at the following address: 2021 Kingsley Ave, Orange Park, FL, 320735174.
What is Tracey Amanda Bleau's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Tracey Amanda Bleau is Medical, and the taxonomy code that classifies this field of practice is 363Am0700X.
When did the Tracey Amanda Bleau receive its 1215023775?
The Tracey Amanda Bleau was issued its 1215023775 on 2006-10-04, which is the date when the organization was assigned this unique identifier.
When was the information regarding Tracey Amanda Bleau most recently updated?
The details pertaining to the Tracey Amanda Bleau, including its address, specialty, and other relevant information, were last refreshed on 2010-07-20.
NPI Number: 1215930425
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