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Individual

PETER ANDREW VITULLI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

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
05615546
AETNA
FL
01
1803436
UNITED
FL
01
2299239
GHI
FL
01
291080
AVMED
FL
01
81700
BCBS
FL
Enumeration date
05/02/2006
Last updated
12/14/2015
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