Healthcare Provider Details

I. General information

NPI: 1649007931
Provider Name (Legal Business Name): BURKE COLLINS THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 SW 33RD AVE STE H2
OCALA FL
34474-4465
US

IV. Provider business mailing address

PO BOX 932184
ATLANTA GA
31193-2184
US

V. Phone/Fax

Practice location:
  • Phone: 800-699-9395
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA STREETER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 800-699-9395