Healthcare Provider Details

I. General information

NPI: 1053493593
Provider Name (Legal Business Name): PATRICIA J. BUTTERBAUGH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA JEAN SANDERS

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 06/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 COOK AVE
ORLANDO FL
32806-2911
US

IV. Provider business mailing address

1725 COOK AVE
ORLANDO FL
32806-2911
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-9017
  • Fax: 321-843-9019
Mailing address:
  • Phone: 321-843-9017
  • Fax: 321-843-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9187794
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9187794
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: