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General NPI Number Information
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NPI Number | 1619923927
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Entity Type | Individual
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Provider Name | KATHLEEN A CULLEN MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 10575 68TH AVE N SUITE A1
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City | SEMINOLE
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State | FL
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Zip | 33772-6035
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Country | US
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Telephone | 727-392-8600
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Fax | 727-392-8686
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Provider Business Mailing Address
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Address Line | 10575 68TH AVE N SUITE A1
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City | SEMINOLE
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State | FL
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Zip | 33772-6035
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Country | US
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Telephone | 727-392-8600
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Fax | 727-392-8686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME70549
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 04-37962
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD.32673
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License Number State | AL
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