Individual
ELEKTRA BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
31 N KROME AVE, HOMESTEAD, FL 33030-6014
(786) 481-5909
Mailing address
10325 SW 112TH ST, MIAMI, FL 33176-3423
(786) 368-5474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
FL
103K00000X
Behavior Analyst
—
FL
1041C0700X
Clinical Social Worker
Primary
SW22096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119802300
—
FL
05
—
120666400
—
FL
Enumeration date
05/11/2022
Last updated
07/17/2024
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