Massullo, Ralph Eugene

Massullo, Ralph Eugene is an individual health care provider with primary practice located at 525 N Dacie Pt , Lecanto FL 34461-8399. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Massullo, Ralph Eugene can be contacted via phone (352) 746-2200.

Contact Information

Primary practice address
525 N Dacie Pt Lecanto FL 34461-8399
Phone: (352) 746-2200
Fax: (352) 746-9320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME54469 Florida
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X ME54469 Florida
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X ME54469 Florida
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X ME54469 Florida

Profile Details

NPI number 1104810563
LBN Legal business name Massullo, Ralph Eugene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Nov 12th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104810563 NPPES
Florida MEDICAID 037329000
Florida Other 070002449

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