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Individual

DR. VICTORIA BUSTAMANTE AVELLANEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
2100 RIVIERA AVE, CLEWISTON, FL 33440-9043
(305) 439-6014
(863) 902-1512
Mailing address
2100 RIVIERA AVE, CLEWISTON, FL 33440-9043
(305) 439-6014
(863) 902-1512

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 5919
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0761575 00
FL
Enumeration date
08/01/2006
Last updated
07/21/2022
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