Provider Demographics
NPI:1063669869
Name:TRAFICANTE, DENISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:TRAFICANTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8127
Mailing Address - Country:US
Mailing Address - Phone:941-979-9085
Mailing Address - Fax:
Practice Address - Street 1:3370 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8127
Practice Address - Country:US
Practice Address - Phone:941-979-9085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264123-1164W00000X
OH03131836183500000X
FLPU83581835P1200X
FLPS54573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy