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NPI Code Detail

MEDICARE: MARY J BURTON AU D

MEDICARE:   MARY J BURTON  AU D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist0451KY
2237700000XHearing Instrument Specialist0923KY
3231H00000XAudiologistAY1803FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00436413OTHERKYMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000381573OTHERKYANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003889015
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J BURTON AU D
Provider Business Mailing Address
First Line : 502 PASADENA AVE S
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33707-2126
Country : US
Telephone Number : 727-289-1212
Fax Number : 727-289-9901
Provider Business Practice Location Address
First Line : 502 PASADENA AVE S
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33707-2126
Country : US
Telephone Number : 727-289-1212
Fax Number : 727-289-9901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 07/21/2022

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