Ralph Eugene Massullo Jr., MD

MOHS-Micrographic Surgery Physician · Lecanto, FL

Individual Active NPI

NPI number 1104810563

Practice location

525 N Dacie PT
Lecanto, FL 34461-8399
Phone
(352) 746-2200
Fax
(352) 746-9320

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NPI record

NPI
1104810563
Entity type
Individual (Type 1)
Enumeration date
August 31, 2005
Last updated
November 12, 2022
Certified
November 12, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
MOHS-Micrographic Surgery Physician Primary 207ND0101X ME54469 FL
Dermatology Physician 207N00000X ME54469 FL
Dermatopathology Physician 207ND0900X ME54469 FL
Procedural Dermatology Physician 207NS0135X ME54469 FL

Mailing address

4651 Van Dyke Rd
Lutz, FL 33558-4880
Phone
(813) 321-1786
Fax
(813) 321-1787

About Dr. Massullo

Ralph Eugene Massullo Jr., MD is a healthcare provider registered in the NPI registry with the primary taxonomy MOHS-Micrographic Surgery Physician (code 207ND0101X). The practice location is 525 N Dacie PT, Lecanto, FL 34461-8399. The NPI number 1104810563 was assigned on August 31, 2005 and the record was last updated on November 12, 2022.

Dr. Massullo lists 4 licenses in the registry: #ME54469 (FL) for MOHS-Micrographic Surgery Physician; #ME54469 (FL) for Dermatology Physician; #ME54469 (FL) for Dermatopathology Physician; #ME54469 (FL) for Procedural Dermatology Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ralph Eugene Massullo Jr., MD?

The NPI number is 1104810563.

What is the phone number of Dr. Massullo?

The phone number listed for the practice location is (352) 746-2200.

Where is Dr. Massullo located?

525 N Dacie PT, Lecanto, FL 34461-8399.

What is the taxonomy code for Dr. Massullo?

The primary taxonomy code is 207ND0101X – MOHS-Micrographic Surgery Physician; 3 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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