Healthcare Provider Details

I. General information

NPI: 1619952207
Provider Name (Legal Business Name): ANNE ELIZABETH BURDICK M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 NW 9TH AVE
MIAMI FL
33136-1406
US

IV. Provider business mailing address

1600 NW 10TH AVE ROOM 2023A (R-250)
MIAMI FL
33136-1015
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6704
  • Fax: 305-243-3503
Mailing address:
  • Phone: 305-243-3780
  • Fax: 305-243-6468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME65826
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: