Individual
PHILIP AMATULLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3680 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 936-3099
Mailing address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 936-3099
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
213214
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME133543
FL
2085R0204X
Vascular & Interventional Radiology Physician
213214
NY
2085R0204X
Vascular & Interventional Radiology Physician
ME133543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01946285
—
NY
05
—
025093200
—
FL
Enumeration date
07/01/2005
Last updated
08/04/2021
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