1427389188 NPI number — ALEXANDRA BURKOWSKY ARNP

Table of content: ALEXANDRA BURKOWSKY ARNP (NPI 1427389188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427389188 NPI number — ALEXANDRA BURKOWSKY ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURKOWSKY
Provider First Name:
ALEXANDRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1427389188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COTOPAXI
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81223-0400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-285-5121
Provider Business Mailing Address Fax Number:
719-218-9994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7481 W. OAKLAND PARK BLVD.
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
LAUDERHILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33319-4985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-852-6672
Provider Business Practice Location Address Fax Number:
305-891-4228
Provider Enumeration Date:
01/20/2010

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: 364SP0808X , with the licence number:  ARNP9202664 , 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: 001845100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com