Healthcare Provider Details

I. General information

NPI: 1619339454
Provider Name (Legal Business Name): SULYNN WALKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 SW 136TH ST
MIAMI FL
33186-5506
US

IV. Provider business mailing address

11750 SW 40TH ST
MIAMI FL
33175-3530
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-0000
  • Fax:
Mailing address:
  • Phone: 305-223-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number140691
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: