Healthcare Provider Details

I. General information

NPI: 1487159778
Provider Name (Legal Business Name): KATHARINE L BURTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 GLADES RD STE 400
BOCA RATON FL
33431-6464
US

IV. Provider business mailing address

670 GLADES RD STE 400
BOCA RATON FL
33431-6464
US

V. Phone/Fax

Practice location:
  • Phone: 856-195-5257
  • Fax:
Mailing address:
  • Phone: 561-955-2572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME148499
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number39200000X
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: