Provider Demographics
NPI:1881258952
Name:DEL BUSTO, CRISTINA TERESA
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:TERESA
Last Name:DEL BUSTO
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 1:5915 PONCE DE LEON BLVD STE 23
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2435
Mailing Address - Country:US
Mailing Address - Phone:786-664-7810
Mailing Address - Fax:
Practice Address - Street 1:5915 PONCE DE LEON BLVD STE 26
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2435
Practice Address - Country:US
Practice Address - Phone:786-664-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent