Provider Demographics
NPI:1508430281
Name:BUTLER, JARROD K
Entity Type:Individual
Prefix:
First Name:JARROD
Middle Name:K
Last Name:BUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10887 NW 17TH ST UNIT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2046
Mailing Address - Country:US
Mailing Address - Phone:786-233-6218
Mailing Address - Fax:
Practice Address - Street 1:10887 NW 17TH ST UNIT 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-2046
Practice Address - Country:US
Practice Address - Phone:786-233-6218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator