Healthcare Provider Details

I. General information

NPI: 1457303679
Provider Name (Legal Business Name): MRS. MAUREEN KULSAR
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 SHOREVIEW DR
ENGLEWOOD FL
34223-5947
US

IV. Provider business mailing address

1080 SHOREVIEW DR
ENGLEWOOD FL
34223-5947
US

V. Phone/Fax

Practice location:
  • Phone: 941-473-8460
  • Fax: 941-473-8460
Mailing address:
  • Phone: 941-473-8460
  • Fax: 941-473-8460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: