CONNOR BURNSIDE DO NPI 1922595990

NPI Information

  • NPI: 1922595990
  • Provider Name: CONNOR BURNSIDE, DO
  • Classification: Psychiatry & Neurology - 2084P0805X
  • Specialization: Geriatric Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2080 MEADOWLAND PARK BLVD
    LAKELAND, FL
    ZIP 33803
  • Phone: (863) 701-2470

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NPI Details

Connor Burnside, DO is a geriatric psychiatry psychiatry neurology in Lakeland, FL. The provider is geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. Connor Burnside, DO NPI is 1922595990. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2080 MEADOWLAND PARK BLVD
LAKELAND, FL
ZIP 33803-326
Phone: (863) 701-2470

The NPI 1922595990 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/16/2018 and was last updated on 9/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0805XPsychiatry & NeurologyGeriatric PsychiatryOS18828FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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