Provider Demographics
NPI:1851554331
Name:TRAVERSO, PURNELL (MD)
Entity Type:Individual
Prefix:DR
First Name:PURNELL
Middle Name:
Last Name:TRAVERSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 CORAL HILLS DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4137
Mailing Address - Country:US
Mailing Address - Phone:954-575-8056
Mailing Address - Fax:
Practice Address - Street 1:3100 CORAL HILLS DR
Practice Address - Street 2:SUITE 305
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4137
Practice Address - Country:US
Practice Address - Phone:954-575-8056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-06
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1189312086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand