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General NPI Number Information
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NPI Number | 1871649566
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Entity Type | Organization
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Legal Business Name | SPINE AND REHAB MEDICINE, P.A.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 1234 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34606
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Country | US
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Telephone | 352-688-3301
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Fax | 352-688-3302
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Provider Business Mailing Address
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Address Line | PO BOX 1989
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City | LUTZ
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State | FL
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Zip | 33548-1989
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Country | US
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Telephone | 352-688-3301
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Fax | 352-688-3302
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUHAS MURLIDHAR KULKARNI
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Credential | M.D.
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Telephone | 352-688-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME0071891
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License Number State | FL
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