Healthcare Provider Details

I. General information

NPI: 1013166248
Provider Name (Legal Business Name): DELRAY TRAUMA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 LINTON BLVD TRAUMA SERVICES
DELRAY BEACH FL
33484-6514
US

IV. Provider business mailing address

PO BOX 480159
FORT LAUDERDALE FL
33348-0159
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-3166
  • Fax:
Mailing address:
  • Phone: 954-491-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. IVAN PUENTE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 954-491-0900