Healthcare Provider Details

I. General information

NPI: 1376273011
Provider Name (Legal Business Name): BUSE YUCEER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 WINTER GARDEN VINELAND RD STE 208
WINDERMERE FL
34786-6098
US

IV. Provider business mailing address

425 W COLONIAL DR
ORLANDO FL
32804-6863
US

V. Phone/Fax

Practice location:
  • Phone: 407-612-4007
  • Fax: 407-612-4017
Mailing address:
  • Phone: 321-332-6947
  • Fax: 407-286-4515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9116028
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9116028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: