MEDICARE: DR. BUTROS LATOUF M.D.

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	207R00000X	Internal Medicine Physician	35064619	OH
2	207R00000X	Internal Medicine Physician	ME164761	FL
3	207R00000X	Internal Medicine Physician	35064619L	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110177263	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851396840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BUTROS LATOUF M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-9100
Fax Number	:	239-343-9108

Provider Business Practice Location Address
First Line	:	42880 CRESCENT LOOP STE 110
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33982-5062
Country	:	US
Telephone Number	:	239-343-3535
Fax Number	:	239-343-4065

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/09/2026

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Directions to “ DR. BUTROS LATOUF M.D.” Practice Location

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