Provider Demographics
NPI:1912690553
Name:DR. THAMAR MAURICE BUTLER MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DR. THAMAR MAURICE BUTLER MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURICE-BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:305-490-6797
Mailing Address - Street 1:66 W FLAGLER ST FL 9
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1887
Mailing Address - Country:US
Mailing Address - Phone:305-490-6797
Mailing Address - Fax:
Practice Address - Street 1:66 W FLAGLER ST FL 9
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1887
Practice Address - Country:US
Practice Address - Phone:305-490-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty