Healthcare Provider Details

I. General information

NPI: 1790996627
Provider Name (Legal Business Name): BRETT ROBERT HUTTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 HAGEN RANCH RD STE B550
BOYNTON BEACH FL
33437-3780
US

IV. Provider business mailing address

10301 HAGEN RANCH RD STE B550
BOYNTON BEACH FL
33437-3780
US

V. Phone/Fax

Practice location:
  • Phone: 561-469-6401
  • Fax: 561-469-6318
Mailing address:
  • Phone: 561-469-6401
  • Fax: 561-469-6318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME102955
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME102955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: