Provider Demographics
NPI:1609090570
Name:BURGOS, IVETTE (REGISTERED NURSE RN)
Entity Type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:REGISTERED NURSE RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC#80 BARRIO ESPINOSA
Mailing Address - Street 2:BUZON 7307
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-870-3370
Mailing Address - Fax:787-767-6600
Practice Address - Street 1:C SERGIO CUEVAS BUSTANANTE 550
Practice Address - Street 2:ASOCIACION DE MAESTROS DE PR PTOSSAM
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-763-5560
Practice Address - Fax:787-767-6600
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20420163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse