Active NPI
Tracey E Cerbone, M.D.
- Neurology Physician
- Port St Lucie, FL
National Provider Identifier
1376562918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- ME59501
- Practice address
- 1651 SE Tiffany Ave
Ste 102
Port St Lucie, FL 34952-7564 - Phone
- (772) 398-1824
- Fax
- (772) 335-2422
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | ME59501 | FL | Primary |
Addresses
Primary practice location
1651 SE Tiffany Ave
Ste 102
Port St Lucie, FL 34952-7564
Mailing address
PO Box 417
Stuart, FL 34995-0417
Phone (772) 223-5665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 256229400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1376562918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417",
"city": "STUART",
"state": "FL",
"postal_code": "349950417",
"telephone_number": "772-223-5665",
"fax_number": "772-223-5646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 SE TIFFANY AVE",
"address_2": "STE 102",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527564",
"telephone_number": "772-398-1824",
"fax_number": "772-335-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERBONE",
"first_name": "TRACEY",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME59501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "256229400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
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- Centre for Eye Care & Surgery Inc
- Centricity Mobile Health Center LLC
- Christina Marie Cepeda, PHARMD
- Ana M Cerpa-Serpa
- Anthony Roody Cesar
- Brianthony Arnold Cesar
- Marie K Cesar, PHD, LMHC, QS
- Rose Brigitte Cesar
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.