Individual
LUIS EDUARDO MONTALVAN-BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
950 NW 20TH ST, MIAMI, FL 33127-4622
(954) 261-2489
Mailing address
3825 POND APPLE DR, WESTON, FL 33332-2161
(954) 261-2489
(954) 261-2489
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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