Individual
DR. MICHAEL KUTRYB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 S WASHINGTON AVE, TITUSVILLE, FL 32780
(210) 267-2020
Mailing address
730 S WASHINGTON AVE, TITUSVILLE, FL 32780-4232
(210) 267-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0068787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0499756
GHI
FL
01
—
180034420
RR MEDICARE
FL
01
—
27322
BCBS
FL
05
—
378367700
—
FL
01
—
6805869003
CIGNA
FL
Enumeration date
06/30/2006
Last updated
11/29/2022
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