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General NPI Number Information
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NPI Number | 1639888407
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Entity Type | Individual
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Provider Name | ANDREA MONIQUE BURTON
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 3491 GANDY BLVD N STE 201
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2654
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Country | US
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Telephone | 727-547-0607
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Fax |
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Provider Business Mailing Address
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Address Line | 15410 DARK STAR LN
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-0140
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Country | US
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Telephone |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CBHCM.0100228
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CBHCM.0100228
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License Number State | FL
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