MEDICARE: BURKE COLLINS THERAPY, INC

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	261QR0400X	Rehabilitation Clinic/Center

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	:	1740878214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURKE COLLINS THERAPY, INC

Provider Business Mailing Address
First Line	:	PO BOX 932184
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-4912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 N WILLIAMSON BLVD STE H2
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-7110
Country	:	US
Telephone Number	:	386-427-4866
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	AMANDA STREETER
Credential	:
Telephone Number	:	800-699-9395

Provider Enumeration Date	:	01/09/2021
Last Update Date	:	12/02/2025

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