Healthcare Provider Details

I. General information

NPI: 1578475877
Provider Name (Legal Business Name): NICHOLAS MICHAEL CUTRO EDD, PSYS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 N MAGNOLIA AVE
ORLANDO FL
32801-1524
US

IV. Provider business mailing address

766 RIVER ROCK BLVD
APOPKA FL
32712-1746
US

V. Phone/Fax

Practice location:
  • Phone: 407-801-2535
  • Fax:
Mailing address:
  • Phone: 954-806-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS1181
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: