Healthcare Provider Details

I. General information

NPI: 1740260819
Provider Name (Legal Business Name): ERIC BUETE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3745 33RD ST N
ST PETERSBURG FL
33713-1506
US

IV. Provider business mailing address

621 SANTA MARIA DR
TIERRA VERDE FL
33715-2013
US

V. Phone/Fax

Practice location:
  • Phone: 727-231-0154
  • Fax: 727-231-0158
Mailing address:
  • Phone: 727-688-6951
  • Fax: 727-231-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number70066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: