Individual
RONALD BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1099 FLORIDA AVE S, ROCKLEDGE, FL 32955-2138
(321) 632-6900
(321) 639-7222
Mailing address
2133 ROCKLEDGE DR, ROCKLEDGE, FL 32955-5401
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
ME19766
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036995100
—
FL
Enumeration date
11/18/2005
Last updated
02/25/2010
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