Provider Demographics
NPI:1942507934
Name:AMBER BURKS, O.D., P.A.
Entity Type:Organization
Organization Name:AMBER BURKS, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD, PA
Authorized Official - Phone:954-571-1701
Mailing Address - Street 1:510 NW 84TH AVE APT 114
Mailing Address - Street 2:#114
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1846
Mailing Address - Country:US
Mailing Address - Phone:954-397-3717
Mailing Address - Fax:954-571-2922
Practice Address - Street 1:100 S MILITARY TRL
Practice Address - Street 2:SUITE 6
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3032
Practice Address - Country:US
Practice Address - Phone:954-571-1701
Practice Address - Fax:954-571-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4576152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty