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Organization

PETER A VITULLI JR D O P A

Active
Other names
A CENTER FOR DERMATOLOGY COSMETIC AND LASER SURGERY
Organization subpart
No

Provider details

NPI number
Authorized official
PETER A VITULLI JR. DO (PHYSICIAN/CEO)
(561) 427-2000
Entity
Organization

Contact information

Practice address
4600 MILITARY TRL, SUITE 107, JUPITER, FL 33458-4810
(561) 427-2000
(561) 776-2565
Mailing address
4600 MILITARY TRL, SUITE 107, JUPITER, FL 33458-4810
(561) 427-2000
(561) 776-2565

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS8005
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81700
MEDICARE- ID TYPE
FL
Enumeration date
05/06/2008
Last updated
09/28/2012
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