Individual
DR. ANTONIO BUSTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
623 AVE PONCE DE LEON, SUITE 601-B HATO REY, SAN JUAN, PR 00917-4820
(787) 518-1054
(787) 750-1472
Mailing address
623 AVE PONCE DE LEON, SUITE 601-B HATO REY, SAN JUAN, PR 00917-4820
(787) 518-1054
(787) 750-1472
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1205
PR
Other
Enumeration date
01/15/2011
Last updated
01/15/2011
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