Provider Demographics
NPI:1942252283
Name:BURGOS, LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUISA
Other - Middle Name:ENERY
Other - Last Name:BURGOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5 A 26
Mailing Address - Street 2:FRANCISCO ZUNIGA FAIR VIEW
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-755-5922
Mailing Address - Fax:787-756-8907
Practice Address - Street 1:5 A 26
Practice Address - Street 2:FRANCISCO ZUNIGA FAIR VIEW
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-755-5922
Practice Address - Fax:787-756-8907
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3991208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics