Individual
RAFAEL MIGUEL BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 S ANDREWS AVE FL 3, FORT LAUDERDALE, FL 33316-2509
(954) 320-3380
(954) 320-3371
Mailing address
1700 NW 49TH ST STE 125, FORT LAUDERDALE, FL 33309-3750
(954) 320-3380
(954) 320-3371
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME137233
FL
390200000X
Student in an Organized Health Care Education/Training Program
TRN14979
FL
Other
Enumeration date
06/17/2010
Last updated
08/09/2019
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