Basic Information
| Provider Information | |||||||||
| NPI: | 1316449978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURDICK | ||||||||
| FirstName: | CLIFFORD | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4050 NE 12TH TER APT 31 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333344601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012484307 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5150 LINTON BLVD | ||||||||
| Address2: | |||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334846543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614981754 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2018 | ||||||||
| LastUpdateDate: | 02/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN9327466 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.