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General NPI Number Information
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NPI Number | 1164960969
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Entity Type | Individual
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Provider Name | MARK STEVEN CUTLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 3350 NORTHEAST 12TH AVENUE SUITE 23761
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City | FORT LAUDERDALE
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State | FL
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Zip | 33307-9997
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Country | US
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Telephone | 954-599-5227
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23761
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City | FORT LAUDERDALE
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State | FL
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Zip | 33307-3761
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME 61729
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License Number State | FL
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