Individual
MRS. MOEZZA BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
130 PABLO ST, LAKELAND, FL 33803-3818
(863) 284-5020
Mailing address
1324 LAKELAND HILLS BLVD., ATTN: MANAGED CARE DEPT., LAKELAND, FL 33805
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9286988
FL
363L00000X
Nurse Practitioner
APRN9286899
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9286988
FL
Other
Enumeration date
09/20/2017
Last updated
07/30/2022
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