Provider Demographics
NPI:1306027362
Name:BURKE, MICHAEL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2623 S SEACREST BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7531
Mailing Address - Country:US
Mailing Address - Phone:561-501-1633
Mailing Address - Fax:561-990-1299
Practice Address - Street 1:2623 S SEACREST BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7531
Practice Address - Country:US
Practice Address - Phone:561-501-1633
Practice Address - Fax:561-990-1299
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2022-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME116530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME116530OtherFL STATE MEDICAL LICENSE