Provider Demographics
NPI:1740260819
Name:BUETE, ERIC (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BUETE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SANTA MARIA DR
Mailing Address - Street 2:
Mailing Address - City:TIERRA VERDE
Mailing Address - State:FL
Mailing Address - Zip Code:33715-2013
Mailing Address - Country:US
Mailing Address - Phone:727-688-6951
Mailing Address - Fax:727-231-0158
Practice Address - Street 1:3745 33RD ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-1506
Practice Address - Country:US
Practice Address - Phone:727-231-0154
Practice Address - Fax:727-231-0158
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL70066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E0044Medicare ID - Type Unspecified
FLG60181Medicare UPIN