Healthcare Provider Details

I. General information

NPI: 1639587413
Provider Name (Legal Business Name): TRAVERSO HAND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CORAL HILLS DR SUITE 305
CORAL SPRINGS FL
33065-4137
US

IV. Provider business mailing address

3100 CORAL HILLS DR SUITE 305
CORAL SPRINGS FL
33065-4137
US

V. Phone/Fax

Practice location:
  • Phone: 954-575-8056
  • Fax: 954-575-2563
Mailing address:
  • Phone: 954-575-8056
  • Fax: 954-575-2563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PURNELL TRAVERSO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-575-8056