Johnny Bustamante

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA23842 Issued in FL

Practice address

3900 NW 79TH Ave Ste 500
Doral, FL 33166-6549

Phone

(305) 591-4181

NPI assigned

Apr 7, 2014

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1891114880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 SW 149TH CIRCLE LN APT 1",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868257",
            "telephone_number": "786-487-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE STE 500",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666549",
            "telephone_number": "305-591-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "JOHNNY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA23842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Dean Burns, CRNA
• Madison M Bushea
• Carolina Busse
• Ana Bustamante, FNP-BC
• Andrea Bustamante
• Joan M Bustelo
• Javier Busutil, DPT
• Bwell Clinical Research Corp.
• Bwell Med Center Corp
• Bwell Medical Center Inc

• Physical Therapy Assistant in Doral, FL
• Providers in Doral, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.