Individual
RICK ALLEN KUKULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5326 SWIFT RIVER CT, BRADENTON, FL 34208-5463
(308) 660-5567
Mailing address
5326 SWIFT RIVER CT, BRADENTON, FL 34208-5463
(308) 660-5567
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24735
NE
2085R0202X
Diagnostic Radiology Physician
35063049
OH
2085R0202X
Diagnostic Radiology Physician
Primary
ME 92993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114009000
—
FL
01
—
SATZW
FLORIDA BLUE
FL
Enumeration date
07/11/2005
Last updated
04/29/2022
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