Provider Demographics
NPI:1821663600
Name:TOSCA KINCHELOW MD PA
Entity Type:Organization
Organization Name:TOSCA KINCHELOW MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOSCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINCHELOW KULENDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-908-9036
Mailing Address - Street 1:6919 W BROWARD BLVD # 218
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2902
Mailing Address - Country:US
Mailing Address - Phone:888-908-9036
Mailing Address - Fax:888-259-8707
Practice Address - Street 1:201 N UNIVERSITY DR STE 110
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2039
Practice Address - Country:US
Practice Address - Phone:889-089-0368
Practice Address - Fax:888-259-8701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOSCA KINCHELOW MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty