Organization
THOMAS J SULTENFUSS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JOESPH SULTENFUSS M.D. (PRESIDENT)
(727) 734-6710
Entity
Organization
Contact information
Practice address
1022 MAIN ST STE R, DUNEDIN, FL 34698-5225
(727) 734-6710
(727) 734-6712
Mailing address
1022 MAIN ST STE R, DUNEDIN, FL 34698-5225
(727) 734-6710
(727) 734-6712
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME34798
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0965599
AETNA
FL
01
—
1000091
UNITED HEALTHCARE
FL
01
—
4235833
AETNA
FL
01
—
62317
BLUE SHIELD
FL
01
—
CL2114
PALMETTO GBA MEDICARE RR
FL
Enumeration date
05/08/2007
Last updated
08/22/2020
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