Provider Demographics
NPI:1710208541
Name:BUTLER, JENNIFER DANIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DANIELLE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5245 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-7847
Mailing Address - Country:US
Mailing Address - Phone:689-444-5086
Mailing Address - Fax:
Practice Address - Street 1:5245 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-7847
Practice Address - Country:US
Practice Address - Phone:689-444-5086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA078259207RS0012X
IL125067944207RS0012X
FLME158277207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine