Healthcare Provider Details

I. General information

NPI: 1962321596
Provider Name (Legal Business Name): ANDREA G BURNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 ATLANTA ST
HOLLYWOOD FL
33021-2715
US

IV. Provider business mailing address

5721 ATLANTA ST
HOLLYWOOD FL
33021-2715
US

V. Phone/Fax

Practice location:
  • Phone: 954-668-5403
  • Fax:
Mailing address:
  • Phone: 954-668-5403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: