MEDICARE: MARIANGELIS BURGOS MILANES MSW

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	1041C0700X	Clinical Social Worker	24855	PR

General Provider Information

NPI Number	:	1861167561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANGELIS BURGOS MILANES MSW

Provider Business Mailing Address
First Line	:	HC 7 BOX 2331
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00731-9206
Country	:	US
Telephone Number	:	939-248-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. GLENVIEW GARDEN CALLE GLEN
Second Line	:	F21 APARTAMENTO A
City	:	PONCE
State	:	PR
Zip	:	00730
Country	:	US
Telephone Number	:	939-248-4292
Fax Number	:

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

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	05/18/2026

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