Healthcare Provider Details

I. General information

NPI: 1659300093
Provider Name (Legal Business Name): HOWARD BUTLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S CONGRESS AVE STE 105
ATLANTIS FL
33462-6635
US

IV. Provider business mailing address

5700 LAKE WORTH RD #204
GREENACRES FL
33463-4727
US

V. Phone/Fax

Practice location:
  • Phone: 561-642-8500
  • Fax:
Mailing address:
  • Phone: 561-968-7968
  • Fax: 561-964-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 50644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: