Healthcare Provider Details

I. General information

NPI: 1003133802
Provider Name (Legal Business Name): KATHLEEN MULLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 SE WILLOUGHBY BLVD
STUART FL
34994-5060
US

IV. Provider business mailing address

8668 KELSO DR
PALM BEACH GARDENS FL
33418-6026
US

V. Phone/Fax

Practice location:
  • Phone: 772-597-3687
  • Fax:
Mailing address:
  • Phone: 561-626-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME38451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: