BURGUNDY PRIME INC (NPI# 1720557150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720557150 |
| Entity Type | Organization |
| Organization Name | BURGUNDY PRIME INC |
| Practice Address |
430 Waymont Ct Ste 100 Lake Mary FL 32746-6745 |
| Practice Telephone | 4078780022 |
| Practice Fax Number | 4073694267 |
| Mailing Telephone | 4078780022 |
| Mailing Fax Number | 4073694267 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |
| Authorized Official Name | ABID MALIK (PRESIDENT) |
| Authorized Official Telephone | 4077778084 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084B0002X |
Psychiatry & Neurology Specialization: Obesity Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0015X |
Psychiatry & Neurology Specialization: Psychosomatic Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
430 WAYMONT CT STE 100 |
| City | LAKE MARY |
| State | FL |
| Zip Code | 32746-6745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286397 | James Maggert | Physical Therapist | Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 | 2020-05-14 |
| 1225663743 | Jamie Pecot | Behavior Technician | 300 International Parkway, 200, Lake Mary, FL 32746 | 2020-03-04 |
| 1619509585 | Dental Associates of Heathrow, LLC | Dentist | Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 | 2020-02-10 |
| 1376185876 | Rinehart Road Surgery Center, LLC | Clinic/Center | 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 | 2019-10-16 |
| 1871140988 | Central Florida Wellness LLC | General Practice | 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 | 2019-08-22 |
| 1326609942 | Antoine Slade I | Behavior Technician | 4876 Rhinehart Road, Lake Mary, FL 32746 | 2019-06-25 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1336610856 | Olivia Laurel Stolz | Physician Assistant | 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 | 2018-12-10 |
| 1881171072 | Elite-star Medical Transport LLC. | Non-emergency Medical Transport (VAN) | 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 | 2018-07-20 |
| 1508351537 | Ariagny Elena Fereira | Speech-Language Pathologist | 145 Middle Street Suite 1101, Lake Mary, FL 32746 | 2018-06-22 |
| Find all providers in zip 32746 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821628561 | Devin Jorge Santiago | Psychiatry & Neurology | 725 Primera Blvd Computer Lab, Lake Mary, FL 33578 | 2020-01-22 |
| 1821131780 | Paul Allen Jacobson | Psychiatry & Neurology | 4044 W Lake Mary Blvd, #410, Lake Mary, FL 32746-2012 | 2007-02-14 |
| 1700933512 | Aikiesha Shelby | Psychiatry & Neurology | 255 Primera Blvd, Suite 160, Lake Mary, FL 32746-2158 | 2007-01-04 |
| 1801818703 | Jeffrey Alan Krotenberg | Psychiatry & Neurology | 305 Waymont Ct, Suite 111, Lake Mary, FL 32746-3566 | 2006-07-23 |
| 1598706442 | Balinder S Chahal | Psychiatry & Neurology | 1355 S International Pkwy, Ste.2491, Lake Mary, FL 32746-1696 | 2006-06-10 |
| 1629051941 | Ryan C. W. Hall, Md, Pa | Psychiatry & Neurology | 2500 W Lake Mary Blvd Ste 219, Lake Mary, FL 32746-3501 | 2005-11-21 |
| 1568901197 | Trinity Psychiatric Health, LLC | Psychiatry & Neurology | 1301 S International Pkwy, Suite 2021, Lake Mary, FL 32746-1409 | 2017-02-15 |
| 1124456587 | Lake Mary Psychiatry and Counseling LLC | Psychiatry & Neurology | 305 Waymont Ct, Ste 111, Lake Mary, FL 32746-3566 | 2013-10-23 |
| 1720261472 | Sherry Labib Gergis | Psychiatry & Neurology | 1301 S International Pkwy, Suite 2021, Lake Mary, FL 32746-1409 | 2007-12-17 |
| 1235359407 | Maxine J Minto | Psychiatry & Neurology | 101 Timberlachen Cir, Suite 201, Lake Mary, FL 32746-6124 | 2007-04-27 |
| Find all providers in LAKE MARY | ||||
Please comment or provide details below to improve the information on BURGUNDY PRIME INC.
| 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.