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1619347317
ROBERT FITZGERALD BURGOS
GROTON, CT
NPI
1619347317
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
(Licence: TX 27988167)
Enumeration Date
2015-10-07
Last Update Date
2015-10-21
Business Address
-- ROBERT FITZGERALD BURGOS IDC
SUBMARINE NAVAL BASE NEW LONDON BOX 159
GROTON, CT 06349-5159
Phone number: 860-694-5464
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Mailing Address
-- ROBERT FITZGERALD BURGOS IDC
62 HICKORY DR
GROTON, CT 06340-2915
Phone number: 956-533-2101
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