Healthcare Provider Details

I. General information

NPI: 1750173670
Provider Name (Legal Business Name): TRAUMA SPECIALISTS OF SOUTH FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 MONET TER
PALM BEACH GARDENS FL
33410-3204
US

IV. Provider business mailing address

4414 FUSCHIA CIR N
PALM BEACH GARDENS FL
33410-5425
US

V. Phone/Fax

Practice location:
  • Phone: 561-262-2085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER PATRICK MANISCALCO
Title or Position: PRESIDENT
Credential: LCSW
Phone: 561-262-2085