Individual
MARK CHARLES SULTZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, PHARMD
Contact information
Practice address
3955 INDIAN RIVER BLVD STE 100, VERO BEACH, FL 32960-4800
(772) 569-2330
(772) 569-2630
Mailing address
3955 INDIAN RIVER BLVD STE 100, VERO BEACH, FL 32960-4800
(772) 569-2330
(772) 569-2630
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAT9105191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9105191
LICENSE
FL
Enumeration date
09/28/2009
Last updated
04/06/2022
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