DR. JOSE OMAR BURGOS (NPI# 1053804997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053804997 |
| Entity Type | Individual |
| Full Name | DR. JOSE OMAR BURGOS |
| Credential | MD |
| Practice Address |
201 N Clyde Morris Blvd Ste 200 Daytona Beach FL 32114-2765 |
| Practice Telephone | 3864254165 |
| Practice Fax Number | 3864257545 |
| Mailing Telephone | 3864254165 |
| Mailing Fax Number | 3864257545 |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2018-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | TRN27047 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807128 | Jose L Burgos | Technician/Technologist | 1116 Ave Ponce De Leon, San Juan, PR 00907-3802 | 2020-10-01 |
| 1124558127 | Jose Antonio Burgos | Pharmacist | Carr Pr-167 Intersection Pr-829, Cvs Pharmacy, Bayamon, PR 00957 | 2017-06-13 |
| 1245437425 | Jose Burgos | Internal Medicine | 10657 Vista Del Sol Dr Ste E, El Paso, TX 79935 | 2007-06-29 |
| 1740262849 | Jose I Burgos | Dentist | 34 Calle Baldorioty, Naguabo, PR 00718-2227 | 2005-11-16 |
| 1528623758 | Jose Julian Burgos | Student in an Organized Health Care Education/Training Program | 388 Zona Ind Reparada 2, Ponce, PR 00716-2347 | 2019-05-02 |
| 1467879890 | Jose Ramon Burgos | Student in an Organized Health Care Education/Training Program | Usa Dental Health Activity, Bldg 38801 Academic Dr, Ste B&c, Ft Gordon, GA 30905-5660 | 2014-03-24 |
| 1609143767 | Jose Francisco Burgos | Pharmacist | 14720 Sw 88th St, Miami, FL 33196-1481 | 2011-11-17 |
| 1124310511 | Jose Alberto Burgos | Registered Nurse | 200 W. Hospital Dr., Whiteriver, AZ 85941-1267 | 2011-05-04 |
| 1982938189 | Jose Luis Burgos | Social Worker | 330 E Live Oak Ave, Arcadia, CA 91006 | 2009-09-22 |
| 1467548990 | Jose Antonio Burgos | Dentist | 70 Calle Georgetti, San Juan, PR 00925-3607 | 2006-10-04 |
| Street Address |
201 N CLYDE MORRIS BLVD STE 200 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346247053 | Lane E Jennings | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2005-07-07 |
| 1427675826 | Luke Travis Babcock | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-07-01 |
| 1689290652 | Sachoya Kaiya Mcdonald | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-06-24 |
| 1316563471 | Martin Quang Tran | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-06-24 |
| 1235755281 | Tyler James Johnson | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-06-24 |
| 1366068876 | Isaiah Antoine Cochran | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-06-20 |
| 1912523713 | Kari Stausmire | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2020-06-18 |
| 1194387738 | Allyssa P Dunn | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2019-07-03 |
| 1356902951 | Joshua Ray Brandon | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114-2765 | 2019-06-25 |
| 1518528124 | Amanda Ali Hussein | Family Medicine | 201 N Clyde Morris Blvd Ste 200, Daytona Beach, FL 32114 | 2019-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063178 | Jordann Wood | Family Medicine | 1890 Lpga Blvd Ste 140, Daytona Beach, FL 32117-7131 | 2019-10-01 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| 1245636042 | Dr Ejaz Ahmed Md Pa | Family Medicine | 405 North Clyde Morris Blvd, Daytona Beach, FL 32114-2730 | 2014-11-06 |
| 1063703833 | Brittany O'dwyer Newton | Family Medicine | 201 N Clyde Morris Blvd Ste 210, Daytona Beach, FL 32114-2765 | 2011-04-27 |
| 1548498561 | Ayodeji Ladele | Family Medicine | 1410 Lpga Blvd Ste 136, Daytona Beach, FL 32117-5146 | 2009-06-29 |
| 1417182932 | Phillip Michael Mele Jr. | Family Medicine | 331 Williams Ave, Daytona Beach, FL 32118-3339 | 2009-05-28 |
| 1326280991 | Kevin Anthony Johnson | Family Medicine | 1400 Hancock Blvd, #1208, Daytona Beach, FL 32114 | 2009-03-29 |
| 1265658744 | Jessika Gil-pineda | Family Medicine | 1300 Red John Dr, Daytona Beach, FL 32124-1075 | 2007-04-17 |
| 1548381049 | Andrew Jonathan Niewald | Family Medicine | 305 Memorial Medical Pkwy Ste 502, Daytona Beach, FL 32117-5169 | 2007-04-02 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.