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General NPI Number Information
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NPI Number | 1063669869
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Entity Type | Individual
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Provider Name | DENISE TRAFICANTE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2008
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 3370 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8127
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Country | US
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Telephone | 941-979-9085
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Fax |
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Provider Business Mailing Address
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Address Line | 3370 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8127
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Country | US
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Telephone | 941-979-9085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 264123-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03131836
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PU8358
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS54573
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License Number State | FL
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