Individual
MELISSA ALEJANDRA ZEGARRA BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1975 S JOHN YOUNG PKWY STE 204, KISSIMMEE, FL 34741-0603
(407) 249-1234
Mailing address
11513 LAKE UNDERHILL RD STE 220, ORLANDO, FL 32825-5001
(407) 249-1234
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME150504
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110588000
—
FL
Enumeration date
07/30/2018
Last updated
07/09/2021
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