Organization
FLORIDA ADVANCED PULMONARY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J SULLIVAN MD (PRESIDENT)
(352) 873-0508
Entity
Organization
Contact information
Practice address
2801 SW COLLEGE ROAD, SUITE 16, OCALA, FL 34474-4447
(352) 873-0508
(352) 861-0260
Mailing address
2801 SW COLLEGE ROAD, SUITE 16, OCALA, FL 34474
(352) 873-0508
(352) 861-0260
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME0063329
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME0063329
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253196800
—
FL
01
—
290011760
RAILROAD MEDICARE
GA
01
—
41854
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/29/2006
Last updated
06/27/2008
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