Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Brandon Bustamante, SW19004

Individual provider Mental Health Counselor · NPI 1366108128

Mr. Brandon Bustamante, SW19004 is a Mental Health Counselor in Tampa, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2021
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Practice location Address checks out

3317 W Gandy Blvd
Tampa, FL 33611-2931
Phone: (813) 902-8600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence SW19004 (FL)

Record details

NPI number1366108128
Entity typeIndividual (Type 1)
GenderMale
Credentials SW19004
Sole proprietorYes
NPI enumeratedNovember 16, 2021
Last updated in NPPESNovember 16, 2021
Certification dateNovember 16, 2021

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