Jose A Burgos

Key facts

NPI

1013788652

Entity type

Individual (NPI type 1)

Primary specialty

Student in an Organized Health Care Education/Training Program 390200000X

License

6609276 (PR)

Practice address

209 Calle Pomarrosas
Humacao, PR 00791-4900

Phone

(939) 247-8118

NPI assigned

Jan 11, 2024

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 25, 2024.

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1013788652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CALLE POMARROSAS",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914900",
            "telephone_number": "939-247-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CALLE POMARROSAS",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914900",
            "telephone_number": "939-247-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "JOSE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "PR",
            "license": "6609276",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PR",
            "license": "6609276",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "6609276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humacao, PR

• Carmen Ines Bou, M.D.
• Bright Retina Practice PR LLC
• Bolivar Burgos
• Cybel Burgos, DO
• Elizabeth Beltran Burgos, MSW
• Joselyn Burgos
• Myriam Burgos
• Maria De Lourdes Buso, MSW
• Roberto Manuel Caban Addarich Sr.
• Tyfannie Cabrera Ramos

All providers in Humacao, PR · Student in an Organized Health Care Education/Training Program in Puerto Rico