Individual
MR. BRANDON BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SW19004
Contact information
Practice address
3317 W GANDY BLVD, TAMPA, FL 33611-2931
(813) 902-8600
Mailing address
3317 W GANDY BLVD, TAMPA, FL 33611-2931
(813) 902-8600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW19004
FL
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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