Provider Demographics
NPI:1043519366
Name:PUSTAVER, ANTON PHILIP (MED/EDS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANTON
Middle Name:PHILIP
Last Name:PUSTAVER
Suffix:
Gender:M
Credentials:MED/EDS, LMHC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:411 BAYFRONT DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-8643
Mailing Address - Country:US
Mailing Address - Phone:561-301-5787
Mailing Address - Fax:352-374-5608
Practice Address - Street 1:411 BAYFRONT DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-8643
Practice Address - Country:US
Practice Address - Phone:561-301-5787
Practice Address - Fax:352-374-5608
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health