Individual
EMILIO BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012
(786) 441-5332
Mailing address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(786) 441-5332
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME146603
FL
Other
Enumeration date
07/10/2018
Last updated
03/31/2021
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