Healthcare Provider Details

I. General information

NPI: 1245329127
Provider Name (Legal Business Name): RONALD S HULSE III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TAMPA GENERAL CIR STE 830
TAMPA FL
33606
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542
US

V. Phone/Fax

Practice location:
  • Phone: 813-251-5511
  • Fax: 813-251-5521
Mailing address:
  • Phone: 813-251-5511
  • Fax: 813-251-5521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME102709
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME102709
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME102709
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: