Dr Ralph Eugene Massullo Jr, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Lecanto, Florida. His current practice location is
525 N Dacie Pt, Lecanto, Florida. You can reach out to his office (for appointments etc.) via phone at
(352) 746-2200.
Dr Ralph Eugene Massullo Jr is licensed to practice in Florida (license number ME54469) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104810563.
Physician's Profile
| Full Name | Dr Ralph Eugene Massullo Jr |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 525 N Dacie Pt, Lecanto, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Ralph Eugene Massullo Jr attended and graduated from in
NPI Data:
- NPI Number: 1104810563
- Provider Enumeration Date: 08/31/2005
- Last Update Date: 11/12/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Ralph Eugene Massullo Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104810563 | NPI | - | NPPES |
| 037329000 | Medicaid | FL | |
| 070002449 | Other | FL | SRRGA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | ME54469 (Florida) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | ME54469 (Florida) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | ME54469 (Florida) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | ME54469 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ralph Eugene Massullo Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Ralph Eugene Massullo Jr, MD
4651 Van Dyke Rd,
Lutz, FL 33558-4880
Ph: (813) 321-1786 | Dr Ralph Eugene Massullo Jr, MD
525 N Dacie Pt,
Lecanto, FL 34461-8399
Ph: (352) 746-2200 |
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