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Contact Information

RALPH E MASSULLO JR, MD
525 N DACIE PT
LECANTO, FL34461-8399
 Phone: 352-746-2200
 Fax: 352-746-9320
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Dermatology

207N00000X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for RALPH E MASSULLO JR · (Male)

NPI # 1104810563
Status Active
Credentials MD
Entity Individual
Enumeration date 08/31/2005
Last updated 11/12/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME54469
  • FL Medicaid 037329000
  • FL Other 070002449 SRRGA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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