Gomez Bustamante, Jorge Mario
Gomez Bustamante, Jorge Mario is an sole proprietor health care provider with primary practice located at 10508 Gibsonton Dr , Riverview FL 33578-5434. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Gomez Bustamante, Jorge Mario can be contacted via phone (855) 226-6633.Contact Information
Primary practice address
10508 Gibsonton Dr
Riverview FL 33578-5434
Phone: (855) 226-6633
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 19770 | Puerto Rico |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN980 | Florida |
Profile Details
| NPI number | 1184133050 |
|---|---|
| LBN Legal business name | Gomez Bustamante, Jorge Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 23rd, 2017 |
| Last updated | Mar 5th, 2024 - about last year |
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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