Provider Demographics
NPI:1033226329
Name:BURFORD, FREDERICK J II (DO)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:J
Last Name:BURFORD
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:13774 PLANTATION RD STE 100
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4461
Practice Address - Country:US
Practice Address - Phone:239-236-7777
Practice Address - Fax:239-245-7028
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005829207Q00000X
FLOS5829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80321OtherFL BC
FL80321Medicare PIN
FL80321OtherFL BC