| Doctor Name: | JUAN BUSTILLO |
| NPI Number: | 1023019833 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME69798 |
| Business Practice Address: | 13774 Plantation Rd Unit 100 Fort Myers, FL - 339124461 |
| Business Phone Number: | 2393493539 |
| Business Fax Number: | 2392177469 |
| Mailing Address: | 3434 Hancock Bridge Pkwy, Ste 301 NORTH FORT MYERS |
| State: | FL |
| Postal Code: | 339037094 |
| Phone Number: | 8778563774 |
| Fax Number: | 2395992625 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 09/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | ME69798 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |