Individual
DR. JOHN E SULLIVAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2439 BEE RIDGE RD, SARASOTA, FL 34239-6304
(941) 955-8076
(941) 955-0453
Mailing address
2439 BEE RIDGE RD, SARASOTA, FL 34239-6304
(941) 955-8076
(941) 955-0453
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME43835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051755100
—
FL
01
—
11754
BCBS
FL
01
—
160051136
MEDICARE RR
FL
01
—
203699396
TAX ID
FL
Enumeration date
05/19/2006
Last updated
04/13/2011
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