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NPI Code Detail

MEDICARE: SALENA BURGESS APRN

MEDICARE: SALENA BURGESS APRN
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
1363LG0600XGerontology Nurse Practitioner11006782FL
2363LA2200XAdult Health Nurse Practitioner11006782FL

General Provider Information

NPI Number : 1639755408
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALENA BURGESS APRN
Provider Business Mailing Address
First Line : 17120 SW 49TH PL
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-4919
Country : US
Telephone Number : 954-985-8045
Fax Number :
Provider Business Practice Location Address
First Line : 3487 NW 30TH ST
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33311-1103
Country : US
Telephone Number : 954-739-6233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2021
Last Update Date : 03/22/2021

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Directions to “ SALENA BURGESS APRN” Practice Location

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