Provider Demographics
NPI:1942293519
Name:CUTLER, ROBERT SETH (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SETH
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13005 SOUTHERN BLVD STE 122
Mailing Address - Street 2:MEDICAL MALL ONE, SUITE 122
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9231
Mailing Address - Country:US
Mailing Address - Phone:561-842-5050
Mailing Address - Fax:561-793-9989
Practice Address - Street 1:13005 SOUTHERN BLVD STE 122
Practice Address - Street 2:MEDICAL MALL ONE, SUITE 122
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9231
Practice Address - Country:US
Practice Address - Phone:561-842-5050
Practice Address - Fax:561-793-9989
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2012-05-28
Deactivation Date:2006-04-19
Deactivation Code:
Reactivation Date:2006-06-12
Provider Licenses
StateLicense IDTaxonomies
FLOS5469208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE12021Medicare UPIN
FLK5477Medicare PIN
FL80092VMedicare PIN
FLBD969Medicare PIN