Healthcare Provider Details

I. General information

NPI: 1962408849
Provider Name (Legal Business Name): GAJANAN A KULKARNI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3367 JADEWOOD CIR
TARPON SPRINGS FL
34688-7214
US

IV. Provider business mailing address

3367 JADEWOOD CIR
TARPON SPRINGS FL
34688-7214
US

V. Phone/Fax

Practice location:
  • Phone: 727-934-5281
  • Fax:
Mailing address:
  • Phone: 727-934-5281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME44512
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME44512
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: