Provider Demographics
NPI:1255508040
Name:KULPA, KEN (RRT)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:
Last Name:KULPA
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N LIBERTY AVE
Mailing Address - Street 2:UNIT G
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2691
Mailing Address - Country:US
Mailing Address - Phone:305-910-7188
Mailing Address - Fax:
Practice Address - Street 1:1005 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4460
Practice Address - Country:US
Practice Address - Phone:305-242-8122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT27762279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRT 2776OtherREGISTERED RESPIRATORY THERAPIST