Provider Demographics
NPI:1265777809
Name:BURTON, TEONIA NICOLE
Entity type:Individual
Prefix:
First Name:TEONIA
Middle Name:NICOLE
Last Name:BURTON
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 1:630 S PARK RD APT 3-19
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8390
Mailing Address - Country:US
Mailing Address - Phone:352-240-5670
Mailing Address - Fax:
Practice Address - Street 1:16821 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2405
Practice Address - Country:US
Practice Address - Phone:786-953-6534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-08
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No376K00000XNursing Service Related ProvidersNurse's Aide