Individual
JOHN T SULLEBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4200 N ARMENIA AVE, SUITE 5, TAMPA, FL 33607-6438
(813) 284-2200
(813) 377-1700
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(813) 528-4975
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
ME62629
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17787
BLUE CROSS BLUE SHIELD
FL
05
—
370815200
—
FL
Enumeration date
06/14/2006
Last updated
09/13/2023
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