Provider Demographics
NPI:1306185970
Name:BUTTS, RONALD C JR (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:BUTTS
Suffix:JR
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 1:12028 MAJESTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-2418
Mailing Address - Country:US
Mailing Address - Phone:727-863-4575
Mailing Address - Fax:727-819-0013
Practice Address - Street 1:12028 MAJESTIC BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2418
Practice Address - Country:US
Practice Address - Phone:727-863-4575
Practice Address - Fax:727-819-0013
Is Sole Proprietor?:No
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS18223OtherFLORIDA PHARMACIST LICENSE