Provider Demographics
NPI:1912136128
Name:KULIK, MONIKA ANNA (PA)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:ANNA
Last Name:KULIK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 SW 4TH COURT
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:352-262-0223
Mailing Address - Fax:
Practice Address - Street 1:5850 CORAL RIDGE DR STE 106
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3379
Practice Address - Country:US
Practice Address - Phone:954-714-8200
Practice Address - Fax:954-840-2626
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104966363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant