Healthcare Provider Details

I. General information

NPI: 1639651326
Provider Name (Legal Business Name): MRS. JUDEEN DIAN BURKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS JUDEEN DIAN WALKER

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 SE 17TH ST STE 100
OCALA FL
34471-5588
US

IV. Provider business mailing address

3515 SE 17TH ST STE 100
OCALA FL
34471-5588
US

V. Phone/Fax

Practice location:
  • Phone: 352-509-9165
  • Fax:
Mailing address:
  • Phone: 352-509-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9333412
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9333412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: