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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