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Individual
PETER K SOUTULLO
Active
Individual
PETER K SOUTULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1859232
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59170283
BCBS
AL
01
—
59170285
BCBS
AL
01
—
G0362
BCBS
FL
01
—
P00134595
PALMETTO GBA-RR MEDICARE
—
Enumeration date
05/15/2006
Last updated
07/08/2007
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