Individual
EBONY BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5132 TENNIS COURT CIR, TAMPA, FL 33617-4718
(813) 521-3760
Mailing address
5132 TENNIS COURT CIR, TAMPA, FL 33617-4718
(813) 521-3760
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
789605
—
FL
Enumeration date
07/30/2020
Last updated
07/30/2020
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