Individual
JANET SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCCA
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, MDC 15, TAMPA, FL 33612-4742
(813) 259-8800
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY14
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600071100
—
FL
01
—
S1785
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/10/2006
Last updated
06/18/2008
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