Maria Lourdes P Burgos

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME0054370 Issued in FL

Practice address

820 E Orange Ave
Eustis, FL 32726-4248

Phone

(352) 589-1999

Fax

(352) 589-5145

NPI assigned

Sep 7, 2006

Last updated

Jan 27, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Ma Lourdes P Burgos Other name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maria Lourdes P Burgos , MD

  • Pediatrics Physician
  • Eustis, FL
  • NPI 1548646334
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1972607349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264248",
            "telephone_number": "352-589-1999",
            "fax_number": "352-589-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E ORANGE AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264248",
            "telephone_number": "352-589-1999",
            "fax_number": "352-589-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "MARIA LOURDES",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0054370",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME54370",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDICARE",
            "identifier": "PD066",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09722",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1200629",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037046100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MA LOURDES",
            "last_name": "BURGOS",
            "middle_name": "P",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maurin Brunet
• Laura Brunner
• Jeannetta Diane Bruso, M.A. CCC SLP
• Scottie Bull
• Teresa Burch, DNP, APRN, FNP-C
• Alexis Burke
• Jeffrey J Bush, M.D.
• Christina Hope Byrd-Young
• C.Y.B. Inc
• Brittany Ann Cabrera, LMT

• Pediatrics Physician in Eustis, FL
• Providers in Eustis, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.