Provider Demographics
NPI:1346593621
Name:RONALD S HULSE III MD PL
Entity Type:Organization
Organization Name:RONALD S HULSE III MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HULSE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:813-251-5511
Mailing Address - Street 1:5 TAMPA GENERAL CIR
Mailing Address - Street 2:SUITE 830
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-251-5511
Mailing Address - Fax:813-251-5521
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:SUITE 830
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-251-5511
Practice Address - Fax:813-251-5521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102709207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001676400Medicaid