Organization
BURL R. BURGESS O.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BURL R. BENTON (PRESIDENT)
(386) 774-6000
Entity
Organization
Contact information
Practice address
2576 S VOLUSIA AVE, ORANGE CITY, FL 32763-9120
(386) 774-6000
Mailing address
2576 S VOLUSIA AVE, ORANGE CITY, FL 32763-9120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/27/2010
Last updated
12/27/2010
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