| NPI | 1053804997 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2018-06-13 |
| Last Updated | 2024-12-16 |
| Mailing Address | 1 Memorial Medical Pkwy Suite 201 Palm Coast, FL 32164 United States Phone: (386) 445-4750 | Fax: (386) 445-4751 📍 View Map |
| Primary Practice Address | 201 N Clyde Morris Blvd Ste 200 Daytona Beach, FL 32114-2765 United States Phone: (386) 425-4165 | Fax: (386) 425-7545 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 207Q00000X – Family Medicine | FL | ME143495 |
| Yes | 207Q00000X – Family Medicine | FL | TRN27047 |
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About NPI 1053804997
Jose Omar Burgos M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053804997. The primary specialty listed is Family Medicine. The provider is located in Daytona Beach, FL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2018-06-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1053804997?
NPI 1053804997 belongs to Jose Omar Burgos M.D., a Family Medicine in Daytona Beach, FL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1053804997 active?
The current status of NPI 1053804997 in the NPPES registry is Active. The record was last updated on 2024-12-16.
What specialty is NPI 1053804997?
NPI 1053804997 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1053804997?
You can verify NPI 1053804997 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1053804997?
The primary practice address on file for NPI 1053804997 is 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1053804997 issued?
NPI 1053804997 was first issued (enumerated) on 2018-06-13. The NPPES record was last updated on 2024-12-16.
Practice Location Map
Jose Omar Burgos is located at 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Jose Omar Burgos. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1053804997. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | ME143495 | FL |
| Family Medicine | TRN27047 | FL |