Provider Demographics
NPI:1326065566
Name:KULYK, TEOFIL B (MD)
Entity Type:Individual
Prefix:DR
First Name:TEOFIL
Middle Name:B
Last Name:KULYK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:540 MEDICAL OAKS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5995
Mailing Address - Country:US
Mailing Address - Phone:813-684-2211
Mailing Address - Fax:813-655-7669
Practice Address - Street 1:105 SOUTHERN OAKS DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-1451
Practice Address - Country:US
Practice Address - Phone:813-754-1869
Practice Address - Fax:813-759-8570
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2022-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME36487207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010807000Medicaid
FL79546UMedicare PIN
FLD58839Medicare UPIN