Sullivan, Michael L

Sullivan, Michael L is an individual health care provider with primary practice located at 1540 S Tamiami Trl Suite 303, Sarasota FL 34239-2930. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Sullivan, Michael L can be contacted via phone (941) 917-8791.

Contact Information

Primary practice address
1540 S Tamiami Trl Suite 303 Sarasota FL 34239-2930
Phone: (941) 917-8791
Fax: (941) 917-8793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA3485 Florida

Profile Details

NPI number 1740205863
LBN Legal business name Sullivan, Michael L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Apr 4th, 2016 - about 9 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 1740205863 NPPES
Florida Other Y00N0 BCBS
Florida MEDICAID 261645900 BCBS
Florida MEDICAID 1154PA BCBS

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