Individual
THOMAS JOSEPH SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 N US HIGHWAY 441, SUITE 810, THE VILLAGES, FL 32159-8975
(352) 674-8700
(352) 674-8714
Mailing address
1020 LAKE SUMTER LNDG, THE VILLAGES, FL 32162-2699
(352) 674-8700
(352) 674-8714
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
173877
NY
207X00000X
Orthopaedic Surgery Physician
Primary
ME122199
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01068506
—
NY
Enumeration date
08/30/2005
Last updated
11/20/2014
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