Active NPI
Caryol-Lynn Rullo
- Specialist
- Fort Pierce, FL
National Provider Identifier
1548834807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 6000 Raintree TRL
Fort Pierce, FL 34982-7510 - Phone
- (772) 475-3907
- NPI assigned
- May 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | FL | Primary | |
| Behavior Technician | 106S00000X | RBT-20-139995 | FL | |
| Voluntary or Charitable Agency | 251V00000X | FL | ||
| Community/Behavioral Health Agency | 251S00000X | FL | ||
| Day Training/Habilitation Specialist | 373H00000X | FL |
Addresses
Primary practice location
6000 Raintree TRL
Fort Pierce, FL 34982-7510
Mailing address
100 S 2ND St # 201
Fort Pierce, FL 34950-4306
Phone (772) 306-6477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109981200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-139995 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1548834807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S 2ND ST # 201",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504306",
"telephone_number": "772-306-6477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 RAINTREE TRL",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349827510",
"telephone_number": "772-475-3907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RULLO",
"first_name": "CARYOL-LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-19",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-139995",
"primary": false
},
{
"code": "251V00000X",
"taxonomy_group": "",
"desc": "Voluntary or Charitable",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109981200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.