Provider Demographics
NPI:1093005514
Name:BUTROUS, HODA (MD)
Entity Type:Individual
Prefix:
First Name:HODA
Middle Name:
Last Name:BUTROUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HODA
Other - Middle Name:
Other - Last Name:REZK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 NW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1101
Mailing Address - Country:US
Mailing Address - Phone:305-355-5348
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1101
Practice Address - Country:US
Practice Address - Phone:305-355-5348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146548207RA0001X
OK34079207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology