Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS9830 | FL |
NPI | 1003850561 |
---|---|
Provider Name | Dr. Timothy M. Burke |
First Address | Sunrise, FL 33323-2865 |
Second Address | Hollywood, FL 33021-5421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |