Provider Demographics
NPI:1770864795
Name:TRACHTENBERG, DANIEL H (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:H
Last Name:TRACHTENBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3546 S OCEAN BLVD
Mailing Address - Street 2:#901
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-5739
Mailing Address - Country:US
Mailing Address - Phone:561-588-0315
Mailing Address - Fax:
Practice Address - Street 1:3546 S OCEAN BLVD
Practice Address - Street 2:#901
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-5739
Practice Address - Country:US
Practice Address - Phone:561-588-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17622085R0202X
PAOS002394L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology