Provider Demographics
NPI:1619952207
Name:BURDICK, ANNE ELIZABETH (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:ELIZABETH
Last Name:BURDICK
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 NW 10TH AVE
Mailing Address - Street 2:ROOM 2023A (R-250)
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1015
Mailing Address - Country:US
Mailing Address - Phone:305-243-3780
Mailing Address - Fax:305-243-6468
Practice Address - Street 1:1444 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1406
Practice Address - Country:US
Practice Address - Phone:305-243-6704
Practice Address - Fax:305-243-3503
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65826174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3712583-00Medicaid
FL18092Medicare UPIN
FLF27781Medicare UPIN