Provider Demographics
NPI:1750557880
Name:PULSIFER, KATHLEEN (DPM)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:PULSIFER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568396
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-8396
Mailing Address - Country:US
Mailing Address - Phone:407-648-4107
Mailing Address - Fax:407-648-4177
Practice Address - Street 1:1200 SOUTH KUHL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1127
Practice Address - Country:US
Practice Address - Phone:407-648-4107
Practice Address - Fax:407-648-4177
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3207213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO3207OtherFLORIDA STATE MEDICAL LIC
FLPO3207OtherFLORIDA STATE MEDICAL LIC
FLAL226YMedicare PIN