Provider Demographics
NPI:1326594284
Name:BUESO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BUESO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14091 SW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4002
Mailing Address - Country:US
Mailing Address - Phone:305-385-0433
Mailing Address - Fax:847-396-2522
Practice Address - Street 1:14091 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4002
Practice Address - Country:US
Practice Address - Phone:305-385-0433
Practice Address - Fax:847-396-2522
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist