Provider Demographics
NPI:1689728289
Name:CUTLER, SCOTT G (MD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:G
Last Name:CUTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4321 N. MACDILL AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6390
Mailing Address - Country:US
Mailing Address - Phone:813-874-9922
Mailing Address - Fax:813-876-8881
Practice Address - Street 1:4321 N. MACDILL AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6390
Practice Address - Country:US
Practice Address - Phone:813-874-9922
Practice Address - Fax:813-876-8881
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47544207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30912OtherBCBS OF FLORIDA
FL4047872OtherAETNA
FL043551100Medicaid
FL4047872OtherAETNA
FL30912Medicare PIN