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NPI Code Detail

MEDICARE: FLORELYN OLAVIDEZ BURGOS

MEDICARE:   FLORELYN OLAVIDEZ 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
1225X00000XOccupational Therapist46TR00468400NJ
2225X00000XOccupational Therapist117959TX

General Provider Information

NPI Number : 1952532756
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORELYN OLAVIDEZ BURGOS
Provider Business Mailing Address
First Line : 6229 JACKSTAFF DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-1171
Country : US
Telephone Number : 201-936-2414
Fax Number :
Provider Business Practice Location Address
First Line : 6229 JACKSTAFF DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-1171
Country : US
Telephone Number : 201-936-2414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2009
Last Update Date : 07/22/2025

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Directions to “ FLORELYN OLAVIDEZ BURGOS ” Practice Location

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