Healthcare Provider Details

I. General information

NPI: 1851815351
Provider Name (Legal Business Name): PAULA BURGIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA BURGIN ARNP

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 SE 1ST AVE STE 101
OCALA FL
34471-0478
US

IV. Provider business mailing address

PO BOX 16568
JACKSONVILLE FL
32245-6568
US

V. Phone/Fax

Practice location:
  • Phone: 352-690-6300
  • Fax: 352-690-6802
Mailing address:
  • Phone: 904-472-2300
  • Fax: 904-472-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3343352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: