Healthcare Provider Details

I. General information

NPI: 1003069204
Provider Name (Legal Business Name): LESLIE ANN BURMAN R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22971 VIA DESONRISA DEL NORTE
BOCA RATON FL
33433
US

IV. Provider business mailing address

10505 AVENIDA DEL RIO
DELRAY BEACH FL
33446-2415
US

V. Phone/Fax

Practice location:
  • Phone: 561-789-7000
  • Fax:
Mailing address:
  • Phone: 561-789-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND 2884
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number811914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: