MEDICARE: DAIRA E SULLIVAN M.S.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	222Q00000X	Developmental Therapist	1558126	FL
3	174400000X	Specialist

General Provider Information

NPI Number	:	1528311438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAIRA E SULLIVAN M.S.ED.

Provider Business Mailing Address
First Line	:	8657 MILESTONE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-3902
Country	:	US
Telephone Number	:	516-974-1539
Fax Number	:

Provider Business Practice Location Address
First Line	:	8657 MILESTONE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34238-3902
Country	:	US
Telephone Number	:	516-974-1539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	02/17/2026

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