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Individual
ROBERT SULLIVAN
Active
Individual
ROBERT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN7872
FL
207RN0300X
Nephrology Physician
Primary
ME103826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00501
MEDICARE GROUP NUMBER
FL
01
—
00634
NEPHROLOGY ASSOCIATES OF CENTRAL FLORIDA PTAN
FL
Enumeration date
01/23/2007
Last updated
09/30/2009
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