Individual
EMILY HOFF-SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2820 GIBSON RD, JACKSONVILLE, FL 32207-4804
(904) 399-3150
(904) 399-3515
Mailing address
PO BOX 17543, JACKSONVILLE, FL 32245-7543
(904) 399-3150
(904) 399-3515
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
043649
GA
174400000X
Specialist
Primary
ME0073341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00772912A
—
GA
01
—
162188000
US DOL
GA
01
—
200027956
RR MEDICARE
GA
01
—
41456
BCBS
FL
01
—
4299040001
DME
GA
Enumeration date
06/01/2005
Last updated
01/05/2010
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