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Individual

MS. CRYSTAL F SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 666-6511
Mailing address
13030 SW 143RD TER, MIAMI, FL 33186-8397
(305) 971-2354
(305) 971-2354

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103646
FL

Other

Enumeration date
06/22/2009
Last updated
01/27/2015
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