DALE R TRAFICANTE MD PA
Urology at Lpga Blvd, Daytona Beach, FL

License number
Florida ME75370
Category
Radiology
Type
Urology
Owner
Name: DR. DALE ROBERT TRAFICANTE MD
Title: OWNER
Phone: (386) 274-5757
Address
Address
1890 Lpga Blvd SUITE 220, Daytona Beach, FL 32117
National Provider ID: 1598015398
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Dale R. Traficante, M.D., PA

1890 Lpga Blvd, Daytona Beach, FL 32117

Registration:
Dec 14, 2001
State ID:
P01000118681
Business type:
Domestic for Profit Corporation
President:
Dale R. Traficante (President)
Agent:
Broadstreet Financial

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