Individual
ANGIE MARY BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 SW 124TH CT, MIAMI, FL 33184-2458
(786) 294-5875
Mailing address
1031 SW 124TH CT, MIAMI, FL 33184-2458
(786) 294-5875
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
163W00000X
Registered Nurse
Primary
RN9551808
FL
Other
Enumeration date
02/07/2017
Last updated
01/06/2021
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