MEDICARE: DAVID A BUTLER DO LLC

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
1	207Q00000X	Family Medicine Physician	OS10915	FL

General Provider Information

NPI Number	:	1669759080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID A BUTLER DO LLC

Provider Business Mailing Address
First Line	:	17801 MURDOCK CIR UNIT C
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-4003
Country	:	US
Telephone Number	:	941-629-3500
Fax Number	:	941-979-9694

Provider Business Practice Location Address
First Line	:	17801 MURDOCK CIR UNIT C
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-4003
Country	:	US
Telephone Number	:	941-629-3500
Fax Number	:	941-979-9694

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID ALLEN BUTLER
Credential	:
Telephone Number	:	941-273-3611

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	05/07/2026

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