Provider Demographics
NPI:1306665088
Name:BUERGO CHAMOSA, BEATRIZ
Entity type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:
Last Name:BUERGO CHAMOSA
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 1:3951 NW 65TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6917
Mailing Address - Country:US
Mailing Address - Phone:786-387-9705
Mailing Address - Fax:
Practice Address - Street 1:3951 NW 65TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6917
Practice Address - Country:US
Practice Address - Phone:786-387-9705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician