Individual
IVELISSE BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 CALLE GEORGETTI, COMERIO, PR 00782-2539
(787) 875-3375
Mailing address
PALACIOS REALES #100 C/BARBERINI, TOA ALTA, PR 00953-4926
(787) 999-2899
(787) 999-2899
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
14476
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21087
TRIPLE S
PR
Enumeration date
06/09/2006
Last updated
09/09/2010
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