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NPI Code Detail

MEDICARE: JOSEPH M KUKLA DPM PA

MEDICARE: JOSEPH M KUKLA DPM PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery PodiatristPO3496FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16503WOTHERFLBCBS

General Provider Information

NPI Number : 1295027373
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH M KUKLA DPM PA
Provider Business Mailing Address
First Line : 8851 BOARDROOM CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-4888
Country : US
Telephone Number : 239-689-8910
Fax Number : 239-433-8999
Provider Business Practice Location Address
First Line : 8851 BOARDROOM CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-4888
Country : US
Telephone Number : 239-481-7000
Fax Number : 239-433-8999
Authorized Official
Title or Position : OWNER
Name : DR. JOSEPH M KUKLA
Credential : DPM
Telephone Number : 239-689-8910
Provider Enumeration Date : 05/09/2011
Last Update Date : 09/06/2011

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Directions to “JOSEPH M KUKLA DPM PA ” Practice Location

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