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NPI Code Detail

MEDICARE: GESSICA VILMA BURNS

MEDICARE: GESSICA VILMA BURNS
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
1235Z00000XSpeech-Language PathologistSA11470FL

Other Identifiers

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

General Provider Information

NPI Number : 1639597495
Entity Type Code : Individual
Provider Name (Legal Business Name) : GESSICA VILMA BURNS
Provider Business Mailing Address
First Line : 12655 AGATITE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-2303
Country : US
Telephone Number : 904-588-5296
Fax Number :
Provider Business Practice Location Address
First Line : 1212 13TH ST N
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3682
Country : US
Telephone Number : 727-741-3405
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2014
Last Update Date : 03/30/2014

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Directions to “ GESSICA VILMA BURNS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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