Provider Demographics
NPI:1215174115
Name:SULKOWSKI, MINA ANGELA (MS)
Entity type:Individual
Prefix:MS
First Name:MINA
Middle Name:ANGELA
Last Name:SULKOWSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18999 BISCAYNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2814
Mailing Address - Country:US
Mailing Address - Phone:305-933-9820
Mailing Address - Fax:305-933-9843
Practice Address - Street 1:18999 BISCAYNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2814
Practice Address - Country:US
Practice Address - Phone:305-933-9820
Practice Address - Fax:305-933-9843
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health