Provider Demographics
NPI:1730112715
Name:BURGOS-TIBURCIO, ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:BURGOS-TIBURCIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 W 68TH ST STE 122
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5502
Mailing Address - Country:US
Mailing Address - Phone:305-200-5705
Mailing Address - Fax:305-392-1217
Practice Address - Street 1:2360 W 68TH ST STE 122
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5502
Practice Address - Country:US
Practice Address - Phone:305-200-5705
Practice Address - Fax:305-392-1217
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104754208M00000X, 207RH0002X
FLME104754207R00000X
MA227704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1703112715OtherBMC
MAJ42238OtherBCBS
MA2127431Medicaid
MA962258OtherNETWORK HEALTH
FL001381800Medicaid
MA510492088OtherUNITED HEALTHCARE
MA7785803OtherCIGNA
MA120983OtherFALLON
MAAA75342OtherHARVARD PILGRIM HEALTHCARE
MA495498OtherTUFTS
MAOX2025Medicare PIN
MA495498OtherTUFTS
FLCJ739UMedicare PIN