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General NPI Number Information
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NPI Number | 1356573430
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Entity Type | Organization
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Legal Business Name | DR STEVE T. BUSSA O.D., P.L.L.C.
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 331 N UNIVERSITY DR STE M2-1200
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City | PLANTATION
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State | FL
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Zip | 33324-1975
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Country | US
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Telephone | 954-625-2388
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Fax | 954-625-2390
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Provider Business Mailing Address
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Address Line | 331 N UNIVERSITY DR STE M2-1200
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City | PLANTATION
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State | FL
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Zip | 33324-1975
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Country | US
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Telephone | 954-625-2388
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Fax | 954-625-2390
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Authorized Official
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Title or Position | CEO
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Name | DR. STEVE TIMOTHY BUSSA
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Credential | OPTOMETRIC PHYSICIAN
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Telephone | 775-232-0513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OPC4301
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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