MEDICARE: DR. JOLITA CELINE BURNS MD

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	207V00000X	Obstetrics & Gynecology Physician	ME88050	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1245278563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOLITA CELINE BURNS MD

Provider Business Mailing Address
First Line	:	1885 PROFESSIONAL PARK CIR
Second Line	:	SUITE 10
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4572
Country	:	US
Telephone Number	:	850-656-0302
Fax Number	:	850-656-6110

Provider Business Practice Location Address
First Line	:	2770 CAPITAL MEDICAL BLVD
Second Line	:	SUITE 110
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8417
Country	:	US
Telephone Number	:	850-877-5589
Fax Number	:	850-942-5793

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	06/03/2013

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