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PATRICIA ANN SULLIVAN-LIEBIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
282 OAK HAVEN DR, MELBOURNE, FL 32940-1810
(321) 863-6531
(321) 254-6196
Mailing address
282 OAK HAVEN DR, MELBOURNE, FL 32940-1810
(321) 863-6531
(321) 254-6196

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1717682
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
302046100
FL
01
430000819
RRMCR
FL
01
G0636
BCBSFL
FL
Enumeration date
08/18/2006
Last updated
04/25/2017
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