Individual
ANNAMARIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
611 E ADAMS ST, JACKSONVILLE, FL 32202-2847
(904) 559-9025
Mailing address
611 E ADAMS ST, JACKSONVILLE, FL 32202-2847
(904) 559-9025
(904) 861-3899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5170
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPC5170
FLORIDA DOH OPTOMETRY LICENSE
FL
01
—
SIOKG
BCBS
FL
Enumeration date
06/25/2013
Last updated
02/21/2019
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