Healthcare Provider Details

I. General information

NPI: 1306289418
Provider Name (Legal Business Name): ANDREW BUELT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 38TH AVE N
ST PETERSBURG FL
33710-1629
US

IV. Provider business mailing address

10000 BAY PINES BLVD
BAY PINES FL
33744-8200
US

V. Phone/Fax

Practice location:
  • Phone: 727-384-1414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number13198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: