Individual
THEODORE P COULURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2521 COUNTRYSIDE BLVD, CLEARWATER, FL 33763-1605
(727) 797-5008
(797) 791-1330
Mailing address
2521 COUNTRYSIDE BLVD, CLEARWATER, FL 33763-1605
(727) 797-5008
(797) 791-1330
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3020
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340368800
—
FL
01
—
P00017734
RAILROAD MEDICARE
FL
Enumeration date
04/24/2006
Last updated
07/11/2008
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