Provider Demographics
NPI:1346931680
Name:GULENKA BUERGO 'LLC'
Entity Type:Organization
Organization Name:GULENKA BUERGO 'LLC'
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GULENKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUERGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-776-0296
Mailing Address - Street 1:6310 NW 63RD WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1518
Mailing Address - Country:US
Mailing Address - Phone:305-776-0296
Mailing Address - Fax:
Practice Address - Street 1:6310 NW 63RD WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-1518
Practice Address - Country:US
Practice Address - Phone:305-776-0296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty