MEDICARE: DR. ANDREW E BURG 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	207Q00000X	Family Medicine Physician	ME91867	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00180092	OTHER	FL	RAIL ROAD MEDICARE
4	P00712233	OTHER	FL	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01585	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427043181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW E BURG MD

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-0001
Country	:	US
Telephone Number	:	941-917-2600
Fax Number	:	941-917-7884

Provider Business Practice Location Address
First Line	:	1040 RIVER HERITAGE BLVD
Second Line	:	SUITE 204
City	:	BRADENTON
State	:	FL
Zip	:	34212-6348
Country	:	US
Telephone Number	:	941-917-7100
Fax Number	:	941-917-7142

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	06/27/2014

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Directions to “ DR. ANDREW E BURG MD” Practice Location

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