MEDICARE: DR. JOHN D BUSOWSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME61504	FL
2	207VM0101X	Maternal & Fetal Medicine Physician	ME61504	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME61504	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1376524553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN D BUSOWSKI MD

Provider Business Mailing Address
First Line	:	2415 N ORANGE AVE STE 402
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-622-0560
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 N ORANGE AVE STE 402
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5505
Country	:	US
Telephone Number	:	407-622-0560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	09/20/2024

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Directions to “ DR. JOHN D BUSOWSKI MD” Practice Location

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