Individual
DR. PATRICK JOSEPH BURBANO DE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-1894
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-1894
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101250905
VA
207W00000X
Ophthalmology Physician
MD477446
PA
2083A0100X
Aerospace Medicine Physician
0101250905
VA
208D00000X
General Practice Physician
0101250905
VA
Other
Enumeration date
08/31/2010
Last updated
01/19/2023
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