Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN11015704 | FL |
NPI | 1013542059 |
---|---|
Provider Name | Meghan Dolores Burgos |
First Address | Altamonte Springs, FL 32701-3623 |
Second Address | Apopka, FL 32703-4947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2020 |
Last Update Date | 06/10/2021 |