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1144227331

NPI Code Detail

MEDICARE: PHILIP AMATULLE MD

MEDICARE: PHILIP AMATULLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	213214	NY
2	2085R0202X	Diagnostic Radiology Physician	213214	NY
3	2085R0204X	Vascular & Interventional Radiology Physician	ME133543	FL
4	2085R0202X	Diagnostic Radiology Physician	ME133543	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144227331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP AMATULLE MD

Provider Business Mailing Address
First Line	:	3660 BROADWAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8005
Country	:	US
Telephone Number	:	239-936-2316
Fax Number	:	239-936-3099

Provider Business Practice Location Address
First Line	:	3680 BROADWAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8005
Country	:	US
Telephone Number	:	239-936-2316
Fax Number	:	239-936-3099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	08/04/2021

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Directions to “ PHILIP AMATULLE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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