Cecilia A Bustamante, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2084 Issued in FL

Practice address

3345 Burns Rd Ste 302
Palm Beach Gardens, FL 33410-4321

Phone

(561) 622-7661

Fax

(561) 622-4651

NPI assigned

Aug 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Joseph Thevenin Jr, MD PA

  • Internal Medicine Physician
  • Palmetto Bay, FL
  • NPI 1760784268
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1053503284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 PRESIDENTIAL WAY",
            "address_2": "SUITE # 21",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334011800",
            "telephone_number": "561-616-3939",
            "fax_number": "561-616-3934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 BURNS RD STE 302",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104321",
            "telephone_number": "561-622-7661",
            "fax_number": "561-622-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "CECILIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gillian Bush, PSY.D.
• Kelly Bush, MS SLP-CCC
• Kienna Bush
• Lauren Bush, PHD
• Ronald G. Bush, M.D.
• Marcia E Butler, CRNA
• Polina Bykovskaya, DENTIST
• Mark Kevin Byrne, PHARMD
• C & M Therapy Consulting, Inc
• C.a.R.E. & Rehabilitation, LLC

• Physician Assistant in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.