Individual
DR. JONATHAN M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
11 FLORIDA PARK DR N, PALM COAST, FL 32137-3866
(386) 445-4734
Mailing address
1890 LPGA BLVD STE 230, DAYTONA BEACH, FL 32117-7131
(386) 274-3336
(386) 274-3660
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003666
OH
Other
Enumeration date
05/25/2010
Last updated
03/31/2021
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