Provider Demographics
NPI:1376861856
Name:VLADISLAVA CULINA, MD P.A.
Entity Type:Organization
Organization Name:VLADISLAVA CULINA, MD P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADISLAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:CULINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-322-0020
Mailing Address - Street 1:PO BOX 85130
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33008-5130
Mailing Address - Country:US
Mailing Address - Phone:954-322-0020
Mailing Address - Fax:954-367-2808
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 604
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4634
Practice Address - Country:US
Practice Address - Phone:954-322-0020
Practice Address - Fax:954-367-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-09
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98601261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDI256ZMedicare PIN