MEDICARE: TEONIA NICOLE BURTON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	374J00000X	Doula
2	174H00000X	Health Educator
3	376K00000X	Nurse's Aide
4	176B00000X	Midwife

General Provider Information

NPI Number	:	1265777809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEONIA NICOLE BURTON

Provider Business Mailing Address
First Line	:	630 S PARK RD APT 3-19
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8390
Country	:	US
Telephone Number	:	352-240-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	16821 NE 6TH AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-2405
Country	:	US
Telephone Number	:	786-953-6534
Fax Number	:

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

Provider Enumeration Date	:	12/08/2012
Last Update Date	:	01/22/2022

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