Provider Demographics
NPI:1114110244
Name:KINCHELOW KULENDRAN, TOSCA (MD)
Entity Type:Individual
Prefix:DR
First Name:TOSCA
Middle Name:
Last Name:KINCHELOW KULENDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TOSCA
Other - Middle Name:
Other - Last Name:KINCHELOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6919 W BROWARD BLVD # 218
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2902
Mailing Address - Country:US
Mailing Address - Phone:888-908-9036
Mailing Address - Fax:888-259-8701
Practice Address - Street 1:15600 NW 67TH AVE STE 306
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2176
Practice Address - Country:US
Practice Address - Phone:888-908-9036
Practice Address - Fax:888-259-8701
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07784200207X00000X, 207XS0106X
FLME99415207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAX053ZMedicare PIN