Individual
DEREK BUSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3000 SW 87TH AVE, MIAMI, FL 33165-3245
(305) 223-5650
Mailing address
3000 SW 87TH AVE, MIAMI, FL 33165-3245
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3439
FL
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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