NPI 1003069022

Randi Marie Bustin, PA

Practitioner Physician Assistant Tampa, FL

Practice location

Address: 1502 E Fowler Ave, Tampa, FL 33612-5416
Phone: (813) 866-0950
Fax: (813) 866-0929
Mailing address: PO Box 82969, Tampa, FL 33682-2969

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA9104629 (FL)

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Registry record

NPI: 1003069022
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Nov 2008
Record last updated: 28 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.