Healthcare Provider Details

I. General information

NPI: 1699855791
Provider Name (Legal Business Name): JEANMARIE BURIGO CONNOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 CHIMNEY CORNER LN APT 2032
JUPITER FL
33458-4802
US

IV. Provider business mailing address

224 CHIMNEY CORNER LN APT 2032
JUPITER FL
33458-4802
US

V. Phone/Fax

Practice location:
  • Phone: 772-678-7474
  • Fax: 772-678-7475
Mailing address:
  • Phone: 772-678-7474
  • Fax: 772-678-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTRN8823
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME99340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: