Healthcare Provider Details

I. General information

NPI: 1326391350
Provider Name (Legal Business Name): DON F KUTIK HEARING SPECIALIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MERRITT ISLAND CSWY
MERRITT ISLAND FL
32952-3674
US

IV. Provider business mailing address

5791 RACEWAY RD
LAKE WORTH FL
33449-5444
US

V. Phone/Fax

Practice location:
  • Phone: 321-449-0033
  • Fax: 321-449-0012
Mailing address:
  • Phone: 561-307-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: