Provider Demographics
NPI:1679011464
Name:MARK CUTLER, M.D.
Entity Type:Organization
Organization Name:MARK CUTLER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-599-5227
Mailing Address - Street 1:PO BOX 23761
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33307-3761
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3350 NE 12TH AVE
Practice Address - Street 2:SUITE 23761
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33307-8512
Practice Address - Country:US
Practice Address - Phone:954-599-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty