Provider Demographics
NPI:1619369600
Name:DR. MICHAEL DENIS BURTON, D.O.
Entity Type:Organization
Organization Name:DR. MICHAEL DENIS BURTON, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DENIS
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-294-8900
Mailing Address - Street 1:1446 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4008
Mailing Address - Country:US
Mailing Address - Phone:305-294-8900
Mailing Address - Fax:
Practice Address - Street 1:1446 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4008
Practice Address - Country:US
Practice Address - Phone:305-294-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82928OtherBCBS
FL82928OtherMEDICARE
FL045992502Medicaid