Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 137374 | FL |
NPI | 1407113475 |
---|---|
Provider Name | Jessica Lynn Burgers |
First Address | Columbus, OH 43214-3998 |
Second Address | Fort Lauderdale, FL 33308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 16/10/2018 |