MEDICARE: JASMINE FLORIDA BURGE

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	363LG0600X	Gerontology Nurse Practitioner	NP1042647	DC
2	363LP2300X	Primary Care Nurse Practitioner	NP1042647	DC

General Provider Information

NPI Number	:	1831811603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE FLORIDA BURGE

Provider Business Mailing Address
First Line	:	1211 E CAPITOL ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-1441
Country	:	US
Telephone Number	:	202-340-9342
Fax Number	:

Provider Business Practice Location Address
First Line	:	2350 WASHINGTON PL NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1070
Country	:	US
Telephone Number	:	202-544-7580
Fax Number	:

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

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	04/06/2023

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Directions to “ JASMINE FLORIDA BURGE ” Practice Location

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