Healthcare Provider Details

I. General information

NPI: 1649278458
Provider Name (Legal Business Name): TIMOTHY G BURKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 05/20/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 LINTON BLVD STE 102
DELRAY BEACH FL
33445-6615
US

IV. Provider business mailing address

4675 LINTON BLVD STE 102
DELRAY BEACH FL
33445-6615
US

V. Phone/Fax

Practice location:
  • Phone: 561-501-7445
  • Fax: 561-562-5061
Mailing address:
  • Phone: 561-501-7445
  • Fax: 561-562-5061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberD0057660
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: