Healthcare Provider Details

I. General information

NPI: 1114110244
Provider Name (Legal Business Name): TOSCA KINCHELOW KULENDRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TOSCA KINCHELOW MD

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 NW 67TH AVE STE 306
MIAMI LAKES FL
33014-2176
US

IV. Provider business mailing address

6919 W BROWARD BLVD # 218
PLANTATION FL
33317-2902
US

V. Phone/Fax

Practice location:
  • Phone: 888-908-9036
  • Fax: 888-259-8701
Mailing address:
  • Phone: 888-908-9036
  • Fax: 888-259-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA07784200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME99415
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA07784200
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME99415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: