Provider Demographics
NPI:1447451505
Name:BURGOS, YANIRA RAQUEL (BSN)
Entity type:Individual
Prefix:MISS
First Name:YANIRA
Middle Name:RAQUEL
Last Name:BURGOS
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. LOS ALMENDROS CALLE 4 G-15
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707
Mailing Address - Country:US
Mailing Address - Phone:787-206-8504
Mailing Address - Fax:
Practice Address - Street 1:AVE. KENNEDY
Practice Address - Street 2:8
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707
Practice Address - Country:US
Practice Address - Phone:787-861-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29954163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency