Sullivan, David

Sullivan, David is an individual health care provider with primary practice located at 2823 Glover Carlton Rd , Perry FL 32348-7640. He recently has only one registered license in Other Service Providers / Home Modifications, which is considered as his primary health care specialty. Sullivan, David can be contacted via phone (850) 584-4775.

Contact Information

Primary practice address
2823 Glover Carlton Rd Perry FL 32348-7640
Phone: (850) 584-4775
Fax: (850) 584-4735
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Home Modifications 171WH0202X JB2110 Florida

Profile Details

NPI number 1053733253
LBN Legal business name Sullivan, David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2014
Last updated Jan 9th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053733253 NPPES
Florida MEDICAID 690734200

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