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1891114880
JOHNNY BUSTAMANTE
DORAL, FL
NPI
1891114880
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA23842)
Enumeration Date
2014-04-07
Last Update Date
2014-04-07
Business Address
-- JOHNNY BUSTAMANTE
3900 NW 79TH AVE STE 500
DORAL, FL 33166-6549
Phone number: 305-591-4181
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Mailing Address
-- JOHNNY BUSTAMANTE
13700 SW 149TH CIRCLE LN APT 1
MIAMI, FL 33186-8257
Phone number: 786-487-5969
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