MEDICARE: DR. GARY BRANDON BURTON M.D.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	D0052974	MD

General Provider Information

NPI Number	:	1871717603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY BRANDON BURTON M.D.

Provider Business Mailing Address
First Line	:	1818 HOLLYWOOD BLVD APT 914
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6858
Country	:	US
Telephone Number	:	240-593-1924
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 N OCEAN DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-3813
Country	:	US
Telephone Number	:	954-758-4526
Fax Number	:

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	10/16/2024

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