Healthcare Provider Details

I. General information

NPI: 1427864008
Provider Name (Legal Business Name): JANET MARIE BUITRON CST, CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ALTAMONTE DR FL 32701
ALTAMONTE SPRINGS FL
32701-4802
US

IV. Provider business mailing address

900 CHIPPENDALE ST
DELTONA FL
32725-5704
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2200
  • Fax:
Mailing address:
  • Phone: 239-425-5292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number100278604
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number1043246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: