Provider Demographics
NPI:1215720768
Name:BURGOS, JOSELYN
Entity type:Individual
Prefix:
First Name:JOSELYN
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VERDE MAR
Mailing Address - Street 2:CALLE 31 #812
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00741
Mailing Address - Country:US
Mailing Address - Phone:787-640-0062
Mailing Address - Fax:
Practice Address - Street 1:URB VERDE MAR
Practice Address - Street 2:CALLE 31 #812
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00741
Practice Address - Country:US
Practice Address - Phone:787-640-0062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1021225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist