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General NPI Number Information
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NPI Number | 1164919296
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Entity Type | Individual
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Provider Name | SOOANN S BURBELLA AP, MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2018
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Last Update Date | 04/14/2018
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Provider Practice Location Address
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Address Line | 2231 NW 34TH TER
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City | COCONUT CREEK
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State | FL
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Zip | 33066-2234
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Country | US
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Telephone | 954-600-2916
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Fax |
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Provider Business Mailing Address
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Address Line | 6695 NW 25TH TER
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1434
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Country | US
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Telephone | 816-286-6118
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 3617
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License Number State | FL
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