SERGIO BUSTOS MUNOZ (NPI# 1821317579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821317579 |
| Entity Type | Individual |
| Full Name | SERGIO BUSTOS MUNOZ |
| Credential | MD |
| Practice Address |
368 Ne Franklin St Lake City FL 32055-3088 |
| Mailing Address |
Po Box 689022 Franklin TN 37068-9022 |
| Practice Telephone | 3862928000 |
| Mailing Telephone | 6157788513 |
| Mailing Fax Number | 6156286877 |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2016-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
ME128466 | FL | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
P2964 | TX | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
FTL# 43665 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200398620 A | 05 | |
| NM | 80287531 | 05 | |
| TX | 284782401 | 05 | |
| TX | 284782403 | 05 | |
| TX | 284782402 | 05 | |
| TX | 284782404 | 05 |
| Street Address |
368 NE FRANKLIN ST |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-3088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457396434 | Paul Richard Schriever | Emergency Medicine | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2006-06-17 |
| 1912410804 | Lake Shore Hma, LLC | Medicare Defined Swing Bed Unit | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-11-14 |
| 1295270007 | Columbia Emergency Group LLC | Physician Assistant | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2017-01-03 |
| 1023428539 | Bobbie Lee Rodgers | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-05-06 |
| 1821417502 | Stephen Helvey | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-10 |
| 1770902512 | Gregory A Dyle | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2014-04-09 |
| 1962758342 | Shands Lake Shore Regional Medical Center | General Acute Care Hospital | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-08-03 |
| 1346500949 | Foremost Anesthesia Staffing LLC | Anesthesiology | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2012-05-17 |
| 1447572037 | Crystal Anne Ferwerda | Pharmacist | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2010-02-23 |
| 1912179227 | Christie Elaine Kennedy | Nurse Practitioner | 368 Ne Franklin St, Lake City, FL 32055 | 2008-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114578853 | Erica Stoller | Pediatrics | 1117 E Hallandale Beach Blvd Ste 1, Hallandale Beach, FL 33009-4488 | 2019-09-24 |
| 1629323001 | Hamza Saeed Elkhidir | Pediatrics | 11252 Sw Kingslake Cir, Port St Lucie, FL 34987-2761 | 2012-07-20 |
| 1629331004 | Natalie Victoria Roebuck Bishop | Pediatrics | 1600 S Andrews Ave Fl Picu7, Fort Lauderdale, FL 33316-2510 | 2012-06-20 |
| 1598061574 | Jennifer Christine Munoz Pareja | Pediatrics | 1611 Nw 12th Ave Fl 6006, Miami, FL 33136-1005 | 2011-02-08 |
| 1720382054 | Ricardo A Queiro | Pediatrics | 1421 Sorolla Ave, Coral Gables, FL 33134-3519 | 2010-12-30 |
| 1245534593 | Carmen E Ocampo Benavides | Pediatrics | 1420 Brickell Bay Dr, Apt #907, Miami, FL 33131-3606 | 2010-12-30 |
| 1114044146 | Chad D Scheller | Pediatrics | 3501 Johnson St Dept Of, Hollywood, FL 33021 | 2007-03-23 |
| 1942370416 | Pediatric Hospital Services of Southwest Florida | Pediatrics | 157 Dockside Cir, Weston, FL 33327-1101 | 2006-11-09 |
| 1861577256 | Mark Swanson | Pediatrics | 92 West Miller Street, Orlando, FL 32806 | 2006-10-26 |
| 1841374295 | Enzo Javier Garcia | Pediatrics | 11760 Sw 40th St Ste 722, Miami, FL 33175-8101 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.