# MICHAEL J KUTRYB MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902921737
- **Authorized official:** MICHAEL J KUTRYB M.D. (PHYSICIAN)
- **Authorized official phone:** (321) 383-7888

## Contact information

- **Practice address:** 730 S WASHINGTON AVE, TITUSVILLE, FL 32780-4232
- **Practice address phone:** (321) 267-2020
- **Mailing address:** 730 S WASHINGTON AVE, TITUSVILLE, FL 32780-4232
- **Mailing address phone:** (321) 267-2020
- **Mailing address fax:** (321) 267-4165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME68787 | FL | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 02/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12051964 | DATE OF BIRTH | FL |