Provider Demographics
NPI:1326228875
Name:ROBERT A. KUTNER, PSY.D. & ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ROBERT A. KUTNER, PSY.D. & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:772-283-3223
Mailing Address - Street 1:611 SW FEDERAL HWY
Mailing Address - Street 2:STE C
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2925
Mailing Address - Country:US
Mailing Address - Phone:772-283-3223
Mailing Address - Fax:
Practice Address - Street 1:611 SW FEDERAL HWY
Practice Address - Street 2:STE C
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2925
Practice Address - Country:US
Practice Address - Phone:772-283-3223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4623103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8154Medicare PIN