Organization
MARINA V KULICK MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA V KULICK M.D. (DIRECTOR/PRESIDNT)
(727) 940-3478
Entity
Organization
Contact information
Practice address
1744 S PINELLAS AVE, TARPON SPRINGS, FL 34689-1939
(727) 940-3478
(727) 940-3480
Mailing address
1744 S PINELLAS AVE, TARPON SPRINGS, FL 34689-1939
(727) 940-3478
(727) 940-3480
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
ME103499
FL
208D00000X
General Practice Physician
ME103499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001860000
—
FL
01
—
CY553A
PTAN
—
Enumeration date
01/25/2010
Last updated
02/25/2015
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