Provider Demographics
NPI:1871836296
Name:CARMEN J ORTIZ-BUTCHER MD PA
Entity Type:Organization
Organization Name:CARMEN J ORTIZ-BUTCHER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORTIZ-BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-546-4465
Mailing Address - Street 1:6305 CABALLERO BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3218
Mailing Address - Country:US
Mailing Address - Phone:786-546-4465
Mailing Address - Fax:305-365-8299
Practice Address - Street 1:6305 CABALLERO BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3218
Practice Address - Country:US
Practice Address - Phone:786-546-4465
Practice Address - Fax:305-365-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 45129207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty