Basic Information
| Provider Information | |||||||||
| NPI: | 1386680452 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUTNER | ||||||||
| FirstName: | IRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | D.O.M. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 5200 NE 2ND AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331372706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057518626 | ||||||||
| FaxNumber: | 3055343974 | ||||||||
| Practice Location | |||||||||
| Address1: | 5200 NE 2ND AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331372706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057518626 | ||||||||
| FaxNumber: | 3055343974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AP1521 | FL | Y | Other Service Providers | Acupuncturist |
No ID Information.