Provider Demographics
NPI:1528780558
Name:MONROY BURGOS, DIANA PATRICIA (NONE)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:PATRICIA
Last Name:MONROY BURGOS
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 ROBERT TRENT JONES DR APT 911
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6281
Mailing Address - Country:US
Mailing Address - Phone:256-335-6710
Mailing Address - Fax:
Practice Address - Street 1:2600 ROBERT TRENT JONES DR APT 911
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6281
Practice Address - Country:US
Practice Address - Phone:256-335-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator