MEDICARE: DR. MARK STEVEN CUTLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME 61729	FL

General Provider Information

NPI Number	:	1164960969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK STEVEN CUTLER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 23761
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33307-3761
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 NORTHEAST 12TH AVENUE
Second Line	:	SUITE 23761
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33307-9997
Country	:	US
Telephone Number	:	954-599-5227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	02/07/2017

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