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Individual

GUSTAVO MIGUEL BANTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME112201
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036063412
IL
01
2136778
CIGNA
AZ
01
328075
UNIVERSAL HEALTHCARE
AZ
01
4016817
AETNA
AZ
01
4500628
BCBS
IL
05
776955
AZ
01
P01137572
RAILROAD MCR
AZ
Enumeration date
07/28/2005
Last updated
07/25/2024
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