Basic Information
Provider Information
NPI: 1275776940
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUELLER
FirstName: HOPE
MiddleName: ANGELA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10002 PRINCESS PALM AVE STE 332
Address2:  
City: TAMPA
State: FL
PostalCode: 336198327
CountryCode: US
TelephoneNumber: 8135717184
FaxNumber: 8136544695
Practice Location
Address1: 27406 CASHFORD CIR
Address2:  
City: WESLEY CHAPEL
State: FL
PostalCode: 335448199
CountryCode: US
TelephoneNumber: 8139948900
FaxNumber: 8553885350
Other Information
ProviderEnumerationDate: 04/10/2009
LastUpdateDate: 09/15/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207YS0123XMD208079LAN Allopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
207YS0123XME144703FLY Allopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery

No ID Information.


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