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General NPI Number Information
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NPI Number | 1932182888
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Entity Type | Individual
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Provider Name | JOHN RICHARD KULAS CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 4800 BELFORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6004
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Country | US
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Telephone | 904-265-4801
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Fax | 904-483-5860
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Provider Business Mailing Address
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Address Line | 4800 BELFORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6004
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Country | US
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Telephone | 904-398-3262
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Fax | 904-265-6409
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R1264971
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP 9263982
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License Number State | FL
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