Healthcare Provider Details

I. General information

NPI: 1487614293
Provider Name (Legal Business Name): BARRY JOSEPH KUTTNER M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 W ATLANTIC AVENUE
DELRAY BEACH FL
33484
US

IV. Provider business mailing address

6140 W ATLANTIC AVE
DELRAY BEACH FL
33484
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-4407
  • Fax: 561-498-4480
Mailing address:
  • Phone: 561-498-4407
  • Fax: 561-498-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME62586
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberME62586
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME62586
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: