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Organization
PINNACLE FAMILY MEDICINE PA
Active
Organization
PINNACLE FAMILY MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES C SULLIVAN MD MBA (PRESIDENT)
(352) 688-2118
Entity
Organization
Contact information
Practice address
120 MEDICAL BLVD, SUITE 108, SPRING HILL, FL 34609-0220
(352) 688-2118
(352) 688-3118
Mailing address
120 MEDICAL BLVD, SUITE 108, SPRING HILL, FL 34609-0220
(352) 688-2118
(352) 688-3118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME88431
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37656
BCBS
FL
01
—
K5407
MEDICARE ID
FL
Enumeration date
05/04/2007
Last updated
05/02/2008
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