Individual
PAUL L VITULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
330 A1A N, SUITE 322, PONTE VEDRA BEACH, FL 32082-1823
(904) 551-0703
(904) 551-0709
Mailing address
915 W MONROE ST STE 100, JACKSONVILLE, FL 32204-1177
(904) 518-1398
(904) 513-0231
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
OS10498
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
OS10498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000818800
—
FL
Enumeration date
06/14/2006
Last updated
12/04/2019
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