Provider Demographics
NPI:1992274104
Name:BRUTUS BUTLER, ROSE BERNARD (APRN, PHMNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:BERNARD
Last Name:BRUTUS BUTLER
Suffix:
Gender:F
Credentials:APRN, PHMNP-BC
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:BERNARD
Other - Last Name:BRUTUS BUTLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, PHMNP-BC
Mailing Address - Street 1:16560 SW 102ND PL
Mailing Address - Street 2:ROSEBIE02@GMAIL.COM
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157
Mailing Address - Country:US
Mailing Address - Phone:786-712-2285
Mailing Address - Fax:
Practice Address - Street 1:10300 SW 216TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1003
Practice Address - Country:US
Practice Address - Phone:305-252-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9493726163WP0808X
FL11040754363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty