Healthcare Provider Details

I. General information

NPI: 1477533552
Provider Name (Legal Business Name): MAURA BUETE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 S TAMIAMI TRL
SARASOTA FL
34239-5106
US

IV. Provider business mailing address

711 SILVERMINE RD
NEW CANAAN CT
06840-4329
US

V. Phone/Fax

Practice location:
  • Phone: 314-888-5233
  • Fax: 203-590-8644
Mailing address:
  • Phone: 314-888-5233
  • Fax: 203-590-8644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberME71595
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberME71595
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0071595
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: