Provider Demographics
NPI:1467400275
Name:CUTLER, JONATHAN M (DPM)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:M
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11412 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8722
Mailing Address - Country:US
Mailing Address - Phone:561-793-6170
Mailing Address - Fax:561-795-3683
Practice Address - Street 1:11412 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8722
Practice Address - Country:US
Practice Address - Phone:561-793-6170
Practice Address - Fax:561-795-3683
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1931213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390049500Medicaid
FL390049500Medicaid
FL65186Medicare ID - Type Unspecified