Individual
ROBERT SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3885 OAKWATER CIR, ORLANDO, FL 32806-6257
(407) 851-5600
(407) 438-0507
Mailing address
3885 OAKWATER CIR, ORLANDO, FL 32806-6257
(407) 851-5600
(407) 438-0507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN7872
FL
207RN0300X
Nephrology Physician
Primary
ME103826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00501
MEDICARE GROUP NUMBER
FL
01
—
00634
NEPHROLOGY ASSOCIATES OF CENTRAL FLORIDA PTAN
FL
Enumeration date
01/23/2007
Last updated
09/30/2009
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