Provider Demographics
NPI:1407040439
Name:BURKE, JAMES MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:BURKE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6016
Mailing Address - Country:US
Mailing Address - Phone:561-391-3636
Mailing Address - Fax:561-395-3041
Practice Address - Street 1:22 SE 6TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-6016
Practice Address - Country:US
Practice Address - Phone:561-391-3636
Practice Address - Fax:561-395-3041
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-03
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3324213ES0103X
CT823213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery