Provider Demographics
NPI:1851815351
Name:BURGIN, PAULA (APRN)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BURGIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:BURGIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 16568
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-6568
Mailing Address - Country:US
Mailing Address - Phone:904-472-2300
Mailing Address - Fax:904-472-2330
Practice Address - Street 1:2801 SE 1ST AVE STE 101
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0478
Practice Address - Country:US
Practice Address - Phone:352-690-6300
Practice Address - Fax:352-690-6802
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3343352363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022059400Medicaid