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General NPI Number Information
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NPI Number | 1144718503
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Entity Type | Individual
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Provider Name | CHELSEA L BUSTAMANTE APRN
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Gender | Female
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 12/23/2022
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Provider Practice Location Address
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Address Line | 1945 BAY RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-2105
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Country | US
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Telephone | 352-483-5633
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 TEMPIC DR
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City | MOUNT DORA
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State | FL
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Zip | 32757-8033
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Country | US
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Telephone | 352-551-6209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9330519
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License Number State | FL
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