Individual
DR. JOHN PATRICK SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12670 WHITEHALL DR, FORT MYERS, FL 33907-3619
(239) 936-3554
(239) 936-8993
Mailing address
12670 WHITEHALL DR, FORT MYERS, FL 33907-3619
(239) 936-3554
(239) 936-8993
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
MD431312
PA
2084N0400X
Neurology Physician
Primary
ME 125693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019108090001
—
PA
05
—
15768800
—
FL
Enumeration date
08/12/2006
Last updated
11/18/2016
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