Provider Demographics
NPI:1659415321
Name:KULAWIK, ELWIRA EWA (DC)
Entity Type:Individual
Prefix:DR
First Name:ELWIRA
Middle Name:EWA
Last Name:KULAWIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 E VENICE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-3191
Mailing Address - Country:US
Mailing Address - Phone:941-486-8126
Mailing Address - Fax:941-412-3599
Practice Address - Street 1:1790 E VENICE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3191
Practice Address - Country:US
Practice Address - Phone:941-486-8126
Practice Address - Fax:941-412-3599
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10483111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB2346Medicare ID - Type Unspecified
NYU72388Medicare UPIN