| Randi Marie Bustin, PA | |
|
1502 E Fowler Ave, Tampa, FL 33612-5416 | |
| (813) 866-0950 | |
| (813) 866-0929 |
| Full Name | Randi Marie Bustin |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 1502 E Fowler Ave, Tampa, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003069022 | NPI | - | NPPES |
| 000694400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9104629 (Florida) | Primary |
| Entity Name | Emergency Medical Associates of Tampa Bay LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023397817 PECOS PAC ID: 3678746674 Enrollment ID: O20111108000728 |
| Entity Name | Observation Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952763682 PECOS PAC ID: 3779872627 Enrollment ID: O20160516001399 |
| Mailing Address | Practice Location Address |
|---|---|
| Randi Marie Bustin, PA Po Box 82969, Tampa, FL 33682-2969 Ph: (813) 866-0930 | Randi Marie Bustin, PA 1502 E Fowler Ave, Tampa, FL 33612-5416 Ph: (813) 866-0950 |
Sara Elizabeth Udani, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10150 Highland Manor Dr Ste 205, Tampa, FL 33610 Phone: 813-259-1013 Fax: 813-254-0396 |
Mrs. Jennifer Rose Baker Koebert, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4001 E Fletcher Ave Fl 6, Tampa, FL 33613 Phone: 813-396-0768 |
Frances Ivelisse Bernardo Mercado, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 813-745-4673 |
Maheen Rahim Jussab Ismail, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 888-663-3488 |
Tracie L Patel, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10740 Palm River Rd Ste 360, Tampa, FL 33619 Phone: 813-844-7585 Fax: 813-844-5877 |
Mr. Anthony Bromagen, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12880 Commodity Pl, Tampa, FL 33626 Phone: 813-343-5500 Fax: 813-343-5506 |
Lauren N. Yates, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 813-745-7365 Fax: 813-449-8618 |