Provider Demographics
NPI:1265438386
Name:KUTNER, ALAN R (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:KUTNER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1801 NE 123RD ST
Mailing Address - Street 2:STE 405
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2884
Mailing Address - Country:US
Mailing Address - Phone:305-674-5925
Mailing Address - Fax:305-674-5927
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:STE 810
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-5925
Practice Address - Fax:305-674-5927
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2020-06-17
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Provider Licenses
StateLicense IDTaxonomies
FLME32823207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049620100Medicaid
D63415Medicare UPIN
FL95323ZMedicare PIN