Provider Demographics
NPI:1942210893
Name:BURIAN, PAMELA LEE (PA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LEE
Last Name:BURIAN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:8390 CHAMPIONS GATE BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8310
Mailing Address - Country:US
Mailing Address - Phone:407-390-1677
Mailing Address - Fax:407-390-1765
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:323-662-0492
Practice Address - Fax:323-662-0196
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2016-07-26
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Provider Licenses
StateLicense IDTaxonomies
CAPA12734363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant