Provider Demographics
NPI:1144451428
Name:LESLIE BURMAN, PA
Entity type:Organization
Organization Name:LESLIE BURMAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:5651-789-7000
Mailing Address - Street 1:22971 VIA DE SONRISA DEL NORTE
Mailing Address - Street 2:THE ATHLETICS CENTER AT BOCA POINTE COUNTRY CLUB
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5999
Mailing Address - Country:US
Mailing Address - Phone:561-789-7000
Mailing Address - Fax:561-431-3900
Practice Address - Street 1:22971 VIA DE SONRISA DEL NORTE
Practice Address - Street 2:THE ATHLETICS CENTER AT BOCA POINTE COUNTRY CLUB
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5999
Practice Address - Country:US
Practice Address - Phone:561-789-7000
Practice Address - Fax:561-431-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty