# SAMUEL D KULICK DPM

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

## Provider details

- **NPI number:** 1417215609
- **Authorized official:** DR. SAMUEL KULICK D.P.M. DPM (PODIATRIST)
- **Authorized official phone:** (904) 731-9293

## Contact information

- **Practice address:** 9397 SAN JOSE BLVD STE 1, JACKSONVILLE, FL 32257-5587
- **Practice address phone:** (904) 731-9293
- **Practice address fax:** (904) 636-0223
- **Mailing address:** 9397 SAN JOSE BLVD STE 1, JACKSONVILLE, FL 32257-5587
- **Mailing address phone:** (904) 731-9293
- **Mailing address fax:** (904) 636-0223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3308 | FL | Yes |

## Other

- **Enumeration date:** 04/25/2012
- **Last updated:** 02/12/2025