Provider Demographics
NPI:1891900130
Name:BURGER, DAN (PTA)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:
Last Name:BURGER
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 TRENT CT APT A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8515
Mailing Address - Country:US
Mailing Address - Phone:954-655-2774
Mailing Address - Fax:
Practice Address - Street 1:8360 TRENT CT APT A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-8515
Practice Address - Country:US
Practice Address - Phone:954-655-2774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20531225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant