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General NPI Number Information
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NPI Number | 1225035751
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Entity Type | Individual
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Provider Name | RALPH JAMES TULLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1640 CHERRY RIDGE DR
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City | LAKE MARY
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State | FL
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Zip | 32746-1945
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Country | US
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Telephone | 321-262-9670
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 CHERRY RIDGE DR
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City | LAKE MARY
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State | FL
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Zip | 32746-1945
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Country | US
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Telephone | 321-262-9670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME45972
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME45972
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License Number State | FL
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