Individual
PORSHA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
220 BARTON BLVD UNIT C-14, ROCKLEDGE, FL 32955-2742
(321) 639-5177
(321) 639-4927
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME140891
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102963000
—
FL
Enumeration date
05/20/2015
Last updated
07/09/2020
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