NPIMap

Organization Active NPI

Trauma and Critical Care Associates, LLC

  • Surgery Physician
  • Fort Lauderdale, FL
National Provider Identifier
1619498946
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TRAUMA AND CRITICAL CARE ASSOCIATES, LLC
Practice address
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone
(954) 491-0900
NPI assigned
Jun 27, 2017
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ivan Puente, M.D.NPI 1003902214
Title
President
Phone
(954) 491-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Surgical Critical Care Physician 2086S0102X NU
Trauma Surgery Physician 2086S0127X NU

Addresses

Primary practice location

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

Mailing address

2006 NE 49TH St
Fort Lauderdale, FL 33308-4524
Phone (954) 210-4120

Other practice location 1

201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone (954) 468-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210827001520 FL Part B Supplier - Clinic/Group Practice 0446655526 Receives reassigned benefits from 14 practitioners
Practice locations: Deerfield Beach, FL; Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

2800 E Commercial Blvd
Ste 102
Ft Lauderdale, FL 33308
Phone (954) 491-0900

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1619498946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 NE 49TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084524",
            "telephone_number": "954-210-4120",
            "fax_number": "954-958-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S ANDREWS AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162510",
            "telephone_number": "954-491-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "330643502",
            "country_code": "US",
            "telephone_number": "954-468-5252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRAUMA AND CRITICAL CARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "PUENTE",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-491-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.