Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME0049399 | FL |
N | 207ND0101X | MOHS-Micrographic Surgeon | ME49399 | FL |
NPI | 1063590149 |
---|---|
Provider Name | Steven Mark Burnett |
First Address | Sarasota, FL 34236 |
Second Address | Sarasota, FL 34236-7787 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 24/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E73164 | (02) |