Provider Demographics
NPI:1487976460
Name:BUTZ, STEFAN E (HIS)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:E
Last Name:BUTZ
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5969 CATTLERIDGE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6050
Mailing Address - Country:US
Mailing Address - Phone:941-806-8622
Mailing Address - Fax:941-377-0808
Practice Address - Street 1:5969 CATTLERIDGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232
Practice Address - Country:US
Practice Address - Phone:941-806-8622
Practice Address - Fax:941-377-0808
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4381237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist