Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME72745 | FL |
NPI | 1003805094 |
---|---|
Provider Name | Phillip E Burns |
First Address | Miami, FL 33173-2539 |
Second Address | Pembroke Pines, FL 33024-6716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 16/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252343100 | (05) | FL |
G63492 | (02) |