MEDICARE: MARINA V KULICK M.D.,MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	ME103499	FL
2	2083P0901X	Public Health & General Preventive Medicine Physician	ME103499	FL
3	208D00000X	General Practice Physician	ME103499	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801033550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA V KULICK M.D.,MPH

Provider Business Mailing Address
First Line	:	5350 SPRING HILL DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-4562
Country	:	US
Telephone Number	:	352-277-5348
Fax Number	:	352-606-2857

Provider Business Practice Location Address
First Line	:	13911 LAKESHORE BLVD STE 107
Second Line	:
City	:	HUDSON
State	:	FL
Zip	:	34667-7102
Country	:	US
Telephone Number	:	727-862-0569
Fax Number	:	727-862-0658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2009
Last Update Date	:	04/07/2026

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