MEDICARE: JUSTIN M BURGOS PTA

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	225200000X	Physical Therapy Assistant	30326	FL

General Provider Information

NPI Number	:	1649864257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN M BURGOS PTA

Provider Business Mailing Address
First Line	:	1244 VOTAW RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703
Country	:	US
Telephone Number	:	956-463-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	2418 E SEMORAN BLVD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-5805
Country	:	US
Telephone Number	:	407-464-0210
Fax Number	:

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	01/27/2026

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Directions to “ JUSTIN M BURGOS PTA” Practice Location

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