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Individual

AMBER SULLINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2050 CLASSIQUE LN, TAVARES, FL 32778-5787
(352) 508-5243
Mailing address
PO BOX 1554, TAVARES, FL 32778-1554

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary
FL

Other

Enumeration date
06/09/2017
Last updated
06/09/2017
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