Organization
GUSTAVO BUSTAMANTE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAVO BUSTAMANTE MD (PRESIDENT)
(407) 841-8925
Entity
Organization
Contact information
Practice address
500 DELANEY AVE, 402, ORLANDO, FL 32801-3850
(407) 841-8925
Mailing address
500 DELANEY AVE, 402, ORLANDO, FL 32801-3850
(407) 841-8925
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
24981
FL
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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