Healthcare Provider Details

I. General information

NPI: 1013542059
Provider Name (Legal Business Name): MEGHAN DOLORES BURGOS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN DOLORES DOYLE

II. Dates (important events)

Enumeration Date: 03/10/2020
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 NEMOURS PKWY
ORLANDO FL
32827-7884
US

IV. Provider business mailing address

10140 CENTURION PKWY N
JACKSONVILLE FL
32256-0532
US

V. Phone/Fax

Practice location:
  • Phone: 407-650-7000
  • Fax:
Mailing address:
  • Phone: 904-697-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN9410676
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11015704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: