MEDICARE: FOUAD M BUTTO MD

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	2080P0202X	Pediatric Cardiology Physician	35059340	OH
2	2080P0202X	Pediatric Cardiology Physician	4301069375	MI
3	2080P0202X	Pediatric Cardiology Physician	ME128404	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000521499	OTHER	OH	ANTHEM
2	000000141277	OTHER	OH	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4127774	OTHER	OH	AETNA
5	P00642157	OTHER	OH	RRMC
6	2414116	OTHER	OH	AETNA
7	01732	OTHER	OH	PARAMOUNT
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	25-01038	OTHER	OH	UHC
10	477986938	OTHER	OH	TRICARE
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730171745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FOUAD M BUTTO MD

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-315-7496
Fax Number	:

Provider Business Practice Location Address
First Line	:	3503 E FRONTAGE RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1742
Country	:	US
Telephone Number	:	813-586-8187
Fax Number	:	813-321-6998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	01/01/2025

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Directions to “ FOUAD M BUTTO MD” Practice Location

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