Provider Demographics
NPI:1497125520
Name:TRABANCO, DAVID JOSE (APRN, AGNP-C, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSE
Last Name:TRABANCO
Suffix:
Gender:M
Credentials:APRN, AGNP-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10771 SW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2022
Mailing Address - Country:US
Mailing Address - Phone:305-271-4700
Mailing Address - Fax:305-553-5271
Practice Address - Street 1:10771 SW 64TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2022
Practice Address - Country:US
Practice Address - Phone:305-271-4700
Practice Address - Fax:305-553-5271
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9337727363L00000X, 363LF0000X, 363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care