Provider Demographics
NPI:1821983826
Name:KULIK, LILLIAN KENDALL (PA-C)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:KENDALL
Last Name:KULIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4077 CORDOVA AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-6020
Mailing Address - Country:US
Mailing Address - Phone:904-485-6469
Mailing Address - Fax:
Practice Address - Street 1:3200 3RD ST S STE 200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6097
Practice Address - Country:US
Practice Address - Phone:904-249-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant