Provider Demographics
NPI:1932262516
Name:BUSCH, HOWARD MARK (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MARK
Last Name:BUSCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12977 SOUTHERN BLVD BLDG 5
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9255
Mailing Address - Country:US
Mailing Address - Phone:561-798-8184
Mailing Address - Fax:561-793-2588
Practice Address - Street 1:12977 SOUTHERN BLVD BLDG 5
Practice Address - Street 2:SUITE 200
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9255
Practice Address - Country:US
Practice Address - Phone:561-798-8184
Practice Address - Fax:561-793-2588
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5200207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0397770001OtherCIGNA
FL82930OtherBCBS
FL064050600Medicaid
FLD60770Medicare UPIN
FL40291Medicare ID - Type Unspecified