Provider Demographics
NPI:1740241652
Name:BOMBINO, AESTHOR EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:AESTHOR
Middle Name:EDUARDO
Last Name:BOMBINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10651 N KENDALL DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1569
Mailing Address - Country:US
Mailing Address - Phone:305-275-7373
Mailing Address - Fax:305-275-7066
Practice Address - Street 1:10651 N KENDALL DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1569
Practice Address - Country:US
Practice Address - Phone:305-275-7373
Practice Address - Fax:305-275-7066
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 80957207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51681Medicare PIN
FLH27258Medicare UPIN