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NPI Code Detail

MEDICARE: MS. LORILEE H BUTLER PA-C

MEDICARE: MS. LORILEE H BUTLER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1245208966
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LORILEE H BUTLER PA-C
Provider Business Mailing Address
First Line : 4850 MILLENIA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32839-6012
Country : US
Telephone Number : 210-488-8331
Fax Number :
Provider Business Practice Location Address
First Line : 4850 MILLENIA BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32839-6012
Country : US
Telephone Number : 210-488-8331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 03/12/2014

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