MEDICARE: BRENNA SULLIVAN FULLERTON M.D.

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	208600000X	Surgery Physician	259770	MA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2086S0120X	Pediatric Surgery Physician	ME150199	FL

General Provider Information

NPI Number	:	1366741720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENNA SULLIVAN FULLERTON M.D.

Provider Business Mailing Address
First Line	:	1720 S ORANGE AVE STE 500
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-2967
Country	:	US
Telephone Number	:	140-754-0100
Fax Number	:	407-540-1011

Provider Business Practice Location Address
First Line	:	1720 S ORANGE AVE STE 500
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-2967
Country	:	US
Telephone Number	:	140-754-0100
Fax Number	:	407-540-1011

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

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	08/20/2021

Similar Medicare Providers

1669426920 — DR. DONALD PLUMLEY MD
Practice Location Address:

1720 S ORANGE AVE STE 500
ORLANDO, FL
32806-2967

Practice Phone: 407-540-1000
Practice Fax: 407-540-1011

1720493505 — GABRIEL JOSE RAMOS-GONZALEZ M.D.
Practice Location Address:

1720 S ORANGE AVE STE 500
ORLANDO, FL
32806-2967

Practice Phone: 407-540-1000
Practice Fax: 407-540-1011

1457080731 — DEVINN SHAVONNE GOREY
Practice Location Address:

1720 S ORANGE AVE STE 500
ORLANDO, FL
32806-2967

Practice Phone: 407-540-1000
Practice Fax: 407-540-1011

1740584382 — MS. REBECCA R POSTON
Practice Location Address:

5526 LAKE MARY JESS SHORES CT
ORLANDO, FL
32839-2967

Practice Phone: 407-858-9403
Practice Fax:

1740234012 — DR. MARC LEVY MD
Practice Location Address:

1720 S ORANGE AVE
ORLANDO, FL
32806-2945

Practice Phone: 407-540-1000
Practice Fax: 407-540-1011

1871676551 — PAT QUIJADA, M.D.
Practice Location Address:

1802 BELLEVUE AVE , SUITE 102
ORLANDO, FL
32806-2933

Practice Phone: 407-843-2967
Practice Fax:

Directions to “ BRENNA SULLIVAN FULLERTON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.