| David A Butler Do Llc | |
|
3005 Caring Way Ste 2 Port Charlotte FL 33952-5304 | |
| (941) 629-3500 | |
| (941) 359-3100 |
| Full Name | David A Butler Do Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3005 Caring Way, Port Charlotte, Florida |
| Authorized Official Name and Position | David A Butler (OWNER) |
| Authorized Official Contact | 9416293500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David A Butler Do Llc 3005 Caring Way Ste 2 Port Charlotte FL 33952-5304 Ph: (941) 629-3500 | David A Butler Do Llc 3005 Caring Way Ste 2 Port Charlotte FL 33952-5304 Ph: (941) 629-3500 |
| NPI Number | 1669759080 |
|---|---|
| Provider Enumeration Date | 11/14/2011 |
| Last Update Date | 04/16/2012 |
| Medicare PECOS PAC ID | 5092981118 |
|---|---|
| Medicare Enrollment ID | O20111220000482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669759080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS10915 (Florida) | Primary |
| Provider Name | Veronica Alessandro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780706507 PECOS PAC ID: 6507801172 Enrollment ID: I20050623000677 |
| Provider Name | David A Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639127996 PECOS PAC ID: 3577526136 Enrollment ID: I20100610000835 |
| Provider Name | Gustavo Adolfo Prada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326337759 PECOS PAC ID: 1254576895 Enrollment ID: I20141204001033 |
| Provider Name | Caleb Christopher Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053965780 PECOS PAC ID: 1153756846 Enrollment ID: I20200128000718 |
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