Healthcare Provider Details

I. General information

NPI: 1528152618
Provider Name (Legal Business Name): MATTHEW ROBERT KULKA D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR
WEST PALM BCH FL
33401-3404
US

IV. Provider business mailing address

1411 N FLAGLER DR STE 4500
WEST PALM BEACH FL
33401-3408
US

V. Phone/Fax

Practice location:
  • Phone: 561-659-5154
  • Fax: 561-659-3820
Mailing address:
  • Phone: 561-659-5154
  • Fax: 561-659-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS15716
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: