Individual
CARLOS ANDRES BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8380 RIVERWALK PARK BLVD STE 100, FORT MYERS, FL 33919-8758
(239) 343-9960
(239) 343-9977
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9960
(239) 343-9977
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME145471
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107405600
—
FL
Enumeration date
04/08/2015
Last updated
04/10/2026
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