Individual
MIA N BULSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 CENTRAL FLORIDA BLVD, ORLANDO, FL 32816-8005
(407) 823-2000
Mailing address
13319 SUNSET SHORE CIR, RIVERVIEW, FL 33579-0007
(813) 503-3425
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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