Individual
MR. CHRISTOPHER JOHN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8900 SE 165TH MULBERRY LN, THE VILLAGES, FL 32162-5884
(352) 674-5070
(352) 384-7954
Mailing address
8900 SE 165TH MULBERRY LN, THE VILLAGES, FL 32162-5884
(352) 674-5070
(352) 384-7954
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME63329
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME0063329
FL
207RP1001X
Pulmonary Disease Physician
ME0063329
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253196800
—
FL
01
—
290011760
RAILROAD MEDICARE
GA
01
—
41854
BLUE CROSS BLUE SHIELD
FL
01
—
9685265001
CIGNA
FL
Enumeration date
07/26/2006
Last updated
09/13/2022
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