Provider Demographics
NPI:1750744058
Name:BURGOS, MARIA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 AVE JESUS T PINERO
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-5544
Mailing Address - Country:US
Mailing Address - Phone:787-738-2495
Mailing Address - Fax:847-396-3124
Practice Address - Street 1:4010 AVE JESUS T PINERO
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-5544
Practice Address - Country:US
Practice Address - Phone:787-738-2495
Practice Address - Fax:847-396-3124
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR44781835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care