Provider Demographics
NPI:1699515627
Name:BURGER, RAYMOND JAMES
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:JAMES
Last Name:BURGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 IRONWOOD CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-6808
Mailing Address - Country:US
Mailing Address - Phone:619-490-9854
Mailing Address - Fax:
Practice Address - Street 1:11350 66TH ST STE 111
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5524
Practice Address - Country:US
Practice Address - Phone:727-504-6539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician