ANDRES BUSTILLO LOPEZ M.D. NPI 1275527749

NPI Information

NPI: 1275527749
Provider Name: ANDRES BUSTILLO LOPEZ, M.D.
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

CLIA Number: 10D2069198

Address:
6705 S RED RD
SUITE 602
SOUTH MIAMI, FL
ZIP 33143
Phone: (305) 663-3380
Get Directions

Andres Bustillo Lopez, M.D. is a facial plastic surgery otolaryngology in South Miami, FL. The provider is an otolaryngologist who specializes in facial plastic surgery. Andres Bustillo Lopez, M.D. NPI is 1275527749. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6705 S RED RD
SUITE 602
SOUTH MIAMI, FL
ZIP 33143-622
Phone: (305) 663-3380
Fax: (786) 533-1535

The CLIA number assigned to this NPI record is 10D2069198 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2005 and was last updated on 2/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Y00000X	Otolaryngology		ME91869	FLORIDA	No
2	207YS0123X	Otolaryngology	Facial Plastic Surgery	ME91869	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	275991800	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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