MEDICARE: BURN AND RECONSTRUCTIVE CENTERS OF FLORIDA, INC.

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1013283803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURN AND RECONSTRUCTIVE CENTERS OF FLORIDA, INC.

Provider Business Mailing Address
First Line	:	1561 LAKEFRONT DR UNIT 202
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-1637
Country	:	US
Telephone Number	:	941-822-8955
Fax Number	:	941-259-0157

Provider Business Practice Location Address
First Line	:	1561 LAKEFRONT DR UNIT 202
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-1637
Country	:	US
Telephone Number	:	941-822-8955
Fax Number	:	941-259-0157

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JOELLEN MARIE FLEMING
Credential	:
Telephone Number	:	941-822-8955

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	12/02/2025

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