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Individual

KERINA LEE BUSTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
12511 WORLD PLAZA LN BLDG 50, FORT MYERS, FL 33907-3991
(239) 343-1000
Mailing address
20651 COUNTRY WALK WAY, ESTERO, FL 33928-2200
(505) 203-8723

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9406123
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
11016816
FL

Other

Enumeration date
06/12/2021
Last updated
12/08/2021
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