Provider Demographics
NPI:1033854989
Name:BURDILES, ALEJANDRA (CDM)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:BURDILES
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OAK RUN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-5122
Mailing Address - Country:US
Mailing Address - Phone:786-227-3607
Mailing Address - Fax:
Practice Address - Street 1:304 S CITRUS AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4706
Practice Address - Country:US
Practice Address - Phone:786-227-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Single Specialty