# MARINA V KULICK MD PLC

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

## Provider details

- **NPI number:** 1154652576
- **Authorized official:** MARINA V KULICK M.D. (DIRECTOR/PRESIDNT)
- **Authorized official phone:** (727) 940-3478

## Contact information

- **Practice address:** 1744 S PINELLAS AVE, TARPON SPRINGS, FL 34689-1939
- **Practice address phone:** (727) 940-3478
- **Practice address fax:** (727) 940-3480
- **Mailing address:** 1744 S PINELLAS AVE, TARPON SPRINGS, FL 34689-1939
- **Mailing address phone:** (727) 940-3478
- **Mailing address fax:** (727) 940-3480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | ME103499 | FL | — |
| 208D00000X | General Practice Physician | ME103499 | FL | — |

## Other

- **Enumeration date:** 01/25/2010
- **Last updated:** 02/25/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001860000 | — | FL |
| 01 | — | CY553A | PTAN | — |