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Individual

SHARON MOORE BUTLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ALF ADMINISTRATOR

Contact information

Practice address
1407 E HOLLAND AVE, TAMPA, FL 33612-6913
(813) 972-1057
(813) 971-4184
Mailing address
1407 E HOLLAND AVE, TAMPA, FL 33612-6913
(813) 972-1057
(813) 971-4184

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11483
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080517162
DEPT OF ELDER AFFAIRS
FL
05
692137096
FL
05
692137098
FL
Enumeration date
07/31/2009
Last updated
07/31/2009
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