Individual
MS. PRISCILLA LEE GULLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,
Contact information
Practice address
2180 A1A S, SUITE 104, ST AUGUSTINE, FL 32080-6591
(904) 347-7497
(904) 797-7812
Mailing address
2180 A1A S, SUITE 104, ST AUGUSTINE, FL 32080-6591
(904) 347-7497
(904) 797-7812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA18779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3881
BLUECROSSBLUESHIELDFL
FL
Enumeration date
06/26/2007
Last updated
04/09/2008
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