Individual
JONATHAN TYLER BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1900 N ALAFAYA TRL STE 900, ORLANDO, FL 32826-4737
(407) 629-2444
(407) 643-2804
Mailing address
1900 N ALAFAYA TRL STE 900, ORLANDO, FL 32826-4737
(407) 629-2444
(407) 643-2804
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9116438
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116706300
—
FL
Enumeration date
08/30/2022
Last updated
04/22/2025
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