1811164668 NPI number — ANA BURGOS RRT

Table of content: ANA BURGOS RRT (NPI 1811164668)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811164668 NPI number — ANA BURGOS RRT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURGOS
Provider First Name:
ANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RRT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811164668
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15350 SW 76 TERACE # 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33193
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-343-8673
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 N KROME AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33030-4460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-242-8122
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2279C0205X , with the licence number:  RT 7080 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RT 7080 . This is a "RESPIRATORY THERAPY LICENSE NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".