Individual
JESSICA BURGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12890 POINSETTIA AVE, SEMINOLE, FL 33776-4317
(727) 280-6643
Mailing address
12890 POINSETTIA AVE, SEMINOLE, FL 33776-4317
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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