Individual
DR. RATHNA BUSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 965-8300
(239) 658-3175
Mailing address
11341 LONGWATER CHASE COURT, FORT MYERS, FL 33908
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME55449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME55449
MEDICAL LICENSE
—
Enumeration date
02/06/2007
Last updated
03/07/2023
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