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Individual

AGATHA CHULU BURDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7300 GROVE RD, BROOKSVILLE, FL 34613-6012
(352) 549-9759
Mailing address
10655 PEARL BERRY LOOP, LAND O LAKES, FL 34638-6938
(720) 254-0058

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11033654
FL

Other

Enumeration date
06/25/2024
Last updated
06/25/2024
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