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General NPI Number Information
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NPI Number | 1063598373
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Entity Type | Individual
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Provider Name | BERNARD L BURGESS JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 3601 SW 160TH AVE SUITE 250
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City | MIRAMAR
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State | FL
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Zip | 33027-6308
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Country | US
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Telephone | 954-399-4645
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Fax | 855-855-2792
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Provider Business Mailing Address
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Address Line | 4601 CAROTHERS PKWY SUITE 360
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City | FRANKLIN
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State | TN
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Zip | 37067-5976
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Country | US
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Telephone | 615-794-8900
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Fax | 615-794-0038
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD0000025546
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License Number State | TN
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