Provider Demographics
NPI:1023396553
Name:BUTLER, STEVEN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:BUTLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1701
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34274-1701
Mailing Address - Country:US
Mailing Address - Phone:941-376-3524
Mailing Address - Fax:
Practice Address - Street 1:6150 14TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-4622
Practice Address - Country:US
Practice Address - Phone:941-756-3582
Practice Address - Fax:941-756-3582
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 32010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist