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NPI Code Detail

MEDICARE: NASHEED BURGESS PA-C

MEDICARE: NASHEED BURGESS PA-C
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
1363A00000XPhysician AssistantPA9116705FL

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 : 1740900539
Entity Type Code : Individual
Provider Name (Legal Business Name) : NASHEED BURGESS PA-C
Provider Business Mailing Address
First Line : PO BOX 746654
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6654
Country : US
Telephone Number : 904-202-2092
Fax Number : 904-376-4075
Provider Business Practice Location Address
First Line : 1301 PALM AVE STE 500
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8457
Country : US
Telephone Number : 904-202-7300
Fax Number : 904-202-2754
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2022
Last Update Date : 01/29/2026

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Directions to “ NASHEED BURGESS PA-C” Practice Location

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