MEDICARE: KATHLEEN A KULESA

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
1	225XH1200X	Hand Occupational Therapist	OT21087	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	007340	OTHER		KAISER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1578607271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN A KULESA

Provider Business Mailing Address
First Line	:	2850 COUNTRYBROOK DR APT F-23
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-4847
Country	:	US
Telephone Number	:	720-289-5864
Fax Number	:

Provider Business Practice Location Address
First Line	:	6474 RIDGE RD
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6748
Country	:	US
Telephone Number	:	278-460-5477
Fax Number	:	727-847-0755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	04/21/2026

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Directions to “ KATHLEEN A KULESA ” Practice Location

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