Provider Demographics
NPI:1710467147
Name:KULAWIK, RENATA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:KULAWIK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 89TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-9616
Mailing Address - Country:US
Mailing Address - Phone:941-586-1623
Mailing Address - Fax:
Practice Address - Street 1:907 25TH DR E
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-2053
Practice Address - Country:US
Practice Address - Phone:941-417-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist