Individual provider Active NPI

Maria Bustillo, M.D.

  • Reproductive Endocrinology Physician
  • South Miami, FL
National Provider Identifier
1720031776
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
ME72915 Issued in FL
Practice address
7300 SW 62ND PL
4TH Floor
South Miami, FL 33143-4806
Phone
(305) 662-7901
Fax
(305) 662-7910
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME72915 FL Primary

Addresses

Primary practice location

7300 SW 62ND PL
4TH Floor
South Miami, FL 33143-4806

Mailing address

7300 SW 62ND PL
4TH Floor
South Miami, FL 33143-4806
Phone (305) 662-7901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 13, 2017 through Jun 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME72915FLMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Institute for Reproductive Medicine Past Accepting new patients

Organizations & group practices 1

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1720031776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 SW 62ND PL",
            "address_2": "4TH FLOOR",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434806",
            "telephone_number": "305-662-7901",
            "fax_number": "305-662-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 SW 62ND PL",
            "address_2": "4TH FLOOR",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434806",
            "telephone_number": "305-662-7901",
            "fax_number": "305-662-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME72915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.