MEDICARE: CARLY BURGOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SI6763	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184398497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY BURGOS

Provider Business Mailing Address
First Line	:	1255 SW MAPLEWOOD DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2312
Country	:	US
Telephone Number	:	954-643-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	737 SW PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-2618
Country	:	US
Telephone Number	:	561-909-9738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	02/10/2026

Similar Medicare Providers

1447042155 — TARA ERIN BORRERO LMHC
Practice Location Address:

21750 GLADES CUT OFF RD
PORT ST LUCIE, FL
34987-2618

Practice Phone: 561-512-2361
Practice Fax:

1801028261 — ROBERT CARRAS M.D.
Practice Location Address:

21 SOUTH RD
PORT WASHINGTON, NY
11050-2618

Practice Phone: 516-883-6220
Practice Fax: 516-883-6220

1033776943 — COMFORT TRAVEL NON-EMERGENCY TRANSPORT LLC
Practice Location Address:

4164 HEATON TER
NORTH PORT, FL
34286-2618

Practice Phone: 941-303-7669
Practice Fax:

1578652657 — DR. CHARLES ANTHONY KELLER D.D.S.
Practice Location Address:

919 MARYLAND AVE E
SAINT PAUL, MN
55106-2618

Practice Phone: 651-776-8355
Practice Fax:

1760544290 — SUZANNE SWANSON INC.
Practice Location Address:

1108 GRAND AVE , #2
SAINT PAUL, MN
55105-2618

Practice Phone: 651-221-9709
Practice Fax:

1801928635 — DR. SUZANNE A DOYLE LCSW
Practice Location Address:

6200 REBER PL
SAINT LOUIS, MO
63139-2618

Practice Phone: 314-644-0270
Practice Fax:

Directions to “ CARLY BURGOS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.