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General NPI Number Information
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NPI Number | 1013166248
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Entity Type | Organization
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Legal Business Name | DELRAY TRAUMA ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 5352 LINTON BLVD TRAUMA SERVICES
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6514
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Country | US
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Telephone | 561-495-3166
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 480159
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City | FORT LAUDERDALE
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State | FL
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Zip | 33348-0159
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Country | US
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Telephone | 954-491-0900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IVAN PUENTE
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Credential | M.D.
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Telephone | 954-491-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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