Bustillo, Vanessa Lucia

Bustillo, Vanessa Lucia is an individual health care provider with primary practice located at 11420 N Kendall Dr Ste 112 , Miami FL 33176-1039. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Bustillo, Vanessa Lucia can be contacted via phone (305) 279-1999.

Contact Information

Primary practice address
11420 N Kendall Dr Ste 112 Miami FL 33176-1039
Phone: (305) 279-1999
Fax: (305) 459-3270
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1184964579
LBN Legal business name Bustillo, Vanessa Lucia
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2013
Last updated Jan 3rd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184964579 NPPES
Florida MEDICAID 019888100

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