Provider Demographics
NPI:1487048492
Name:SCOTT G. CUTLER
Entity type:Organization
Organization Name:SCOTT G. CUTLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:G
Authorized Official - Last Name:CUTLER, MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-874-9922
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:33607-6388
Practice Address - Country:US
Practice Address - Phone:813-874-9922
Practice Address - Fax:813-876-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47544207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043551100Medicaid
FL30912OtherBLUE CROSS BLUE SHIELD
FLC65571Medicare UPIN
FL043551100Medicaid