Individual
CARLOS I BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20814 W DIXIE HIGHWAY, AVENTURA, FL 33180
(305) 933-8433
(305) 933-9115
Mailing address
20814 W DIXIE HIGHWAY, AVENTURA, FL 33180
(305) 933-8433
(305) 933-9115
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0059145
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054309800
—
FL
Enumeration date
06/22/2006
Last updated
12/20/2011
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