Healthcare Provider Details

I. General information

NPI: 1265777809
Provider Name (Legal Business Name): TEONIA NICOLE BURTON LM,CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2012
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 GRIFFIN RD STE 310
DAVIE FL
33314-4416
US

IV. Provider business mailing address

PO BOX 4581
HOLLYWOOD FL
33083-4581
US

V. Phone/Fax

Practice location:
  • Phone: 786-750-9552
  • Fax:
Mailing address:
  • Phone: 786-750-9552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW431
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: