Individual
HARLEE ANN MARIE BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1190 NW 95TH ST, SUITE 101, MIAMI, FL 33150-2063
(305) 691-2941
(305) 696-4435
Mailing address
1190 NW 95TH ST, SUITE 101, MIAMI, FL 33150-2063
(305) 691-2941
(305) 696-4435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106848
FL
363AS0400X
Surgical Physician Assistant
PA9106848
FL
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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