Provider Demographics
NPI:1124048715
Name:BURNS, ESTIBALIZ ALOMAR (MD)
Entity type:Individual
Prefix:DR
First Name:ESTIBALIZ
Middle Name:ALOMAR
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ESTIBALIZ
Other - Middle Name:
Other - Last Name:ALOMAR-MELERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:750 NE 13TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5010
Mailing Address - Country:US
Mailing Address - Phone:405-271-4351
Mailing Address - Fax:
Practice Address - Street 1:750 NE 13TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5010
Practice Address - Country:US
Practice Address - Phone:405-271-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95340207L00000X
OK27460207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511087533AMedicaid
FL275146100Medicaid
I62809Medicare UPIN
U8236ZMedicare PIN
FL275146100Medicaid