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Organization
RALPH J. TULLO, MD, PA
Active
Organization
RALPH J. TULLO, MD, PA
Active
Other names
Breast Health Institute of Orlando
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA TULLO B.S.N., C.M.S.R. (ADMINISTRATOR/BILLING COORDINATOR)
(407) 699-6266
Entity
Organization
Contact information
Practice address
300 N LAKE DESTINY RD, MAITLAND, FL 32751-4103
(407) 699-6266
(407) 699-6266
Mailing address
300 NORTH LAKE DESTINY ROAD, MAITLAND, FL 32751-4103
(407) 699-6266
(407) 699-6266
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236228
ACR FACILITY ID NUMBER
FL
01
—
5603
MAITLAND OCCUPATIONAL LIC
FL
Enumeration date
06/30/2005
Last updated
03/25/2008
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