Individual
DR. RALPH EUGENE MASSULLO JR.
Active
Individual
DR. RALPH EUGENE MASSULLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME54469
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME54469
FL
207ND0900X
Dermatopathology Physician
ME54469
FL
207NS0135X
Procedural Dermatology Physician
ME54469
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037329000
—
FL
01
—
070002449
SRRGA
FL
Enumeration date
08/31/2005
Last updated
11/12/2022
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