Individual provider Active NPI

Eduardo Jesus Bustillo, RMFTI, PMHNP

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Miami, FL
National Provider Identifier
1356101729
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
APRN11041075 Issued in FL
Practice address
8900 SW 117TH Ave Ste C205
Miami, FL 33186-2185
Phone
(305) 640-8600
Fax
(954) 248-1973
NPI assigned
Mar 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9194886 FL
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X APRN11041075 FL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11041075 FL
Marriage & Family Therapist 106H00000X IMT4281 FL

Addresses

Primary practice location

8900 SW 117TH Ave Ste C205
Miami, FL 33186-2185

Mailing address

8900 SW 117TH Ave Ste C205
Miami, FL 33186-2185
Phone (305) 640-8600

Other identifiers 1

IdentifierTypeStateIssuer
130350300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250911001683 FL Practitioner - Nurse Practitioner 7315440815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

651 W 35TH St
Hialeah, FL 33012-5128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
IMT4281FLMDMarriage & Family Therapist
9194886FLMDRegistered Nurse
APRN11041075FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobehavioral Health Corp CurrentSince Aug 1, 2025 Accepting new patients
Totus Tuus CurrentSince Aug 29, 2025 Accepting new patients

Locations

12060 SW 129th Ct
Ste 201
Miami, FL 33186
Phone (786) 615-3349

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1356101729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 SW 117TH AVE STE C205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862185",
            "telephone_number": "305-640-8600",
            "fax_number": "954-248-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SW 117TH AVE STE C205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862185",
            "telephone_number": "305-640-8600",
            "fax_number": "954-248-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "EDUARDO",
        "middle_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "RMFTI, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9194886",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11041075",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11041075",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130350300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.