Individual
JESSICA BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2020
Mailing address
PO BOX 17540, PLANTATION, FL 33318-7540
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292118900
—
FL
Enumeration date
12/22/2005
Last updated
10/21/2008
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