Provider Demographics
NPI:1902621410
Name:DR MATTHEW KULKA PLLC
Entity type:Organization
Organization Name:DR MATTHEW KULKA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:KULKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-595-7911
Mailing Address - Street 1:1411 N FLAGLER DR STE 4500
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3408
Mailing Address - Country:US
Mailing Address - Phone:561-659-5154
Mailing Address - Fax:561-659-3820
Practice Address - Street 1:1411 N FLAGLER DR STE 4500
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3408
Practice Address - Country:US
Practice Address - Phone:561-659-5154
Practice Address - Fax:561-659-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty