Provider Demographics
NPI:1336173673
Name:EDWARD L CUTLER MD FA CP PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:EDWARD L CUTLER MD FA CP PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD FACP PROFESSOR ASSOCIATION
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-274-9274
Mailing Address - Street 1:8950 N KENDAL DR
Mailing Address - Street 2:#405
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-274-9274
Mailing Address - Fax:305-274-9264
Practice Address - Street 1:6204 PARADISE POINT DR
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-2645
Practice Address - Country:US
Practice Address - Phone:305-299-4290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME4882207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4882OtherFLORIDA MEDICAL LICENSE
FL4882OtherFLORIDA MEDICAL LICENSE
D86406Medicare UPIN