Healthcare Provider Details

I. General information

NPI: 1487571964
Provider Name (Legal Business Name): ANTONIO RULL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

4134 APPLE BLOSSOM RD
LUTZ FL
33558-2718
US

V. Phone/Fax

Practice location:
  • Phone: 135-226-5992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN9667635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: