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MARIA LOURDES P BURGOS

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1972607349

Individual Registrant:
 MARIA LOURDES P BURGOS 
Gender: F
Sole Proprietor

Location and contact information for practice:
820 E ORANGE AVE  EUSTIS, FL 32726-4248 US
Tel: 352-589-1999  Fax: 352-589-5145

Contact information for business:
820 E ORANGE AVE  EUSTIS, FL 32726-4248 US
Tel: 352-589-1999  Fax: 352-589-5145

Registration Information:
NPI: 1972607349
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
FLME0054370
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
FLME54370

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
037046100FL05
PEDICAREPD066FL01
UNITED HEALTHCARE1200629FL01
BLUE CROSS BLUE SHIELD09722FL01




HEALTH CARE JOBS FL - Page 1



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