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NPI Code Detail

MEDICARE: BRITTANY SULLIVAN DO

MEDICARE: BRITTANY SULLIVAN DO
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
1207R00000XInternal Medicine Physician91289SC
2207R00000XInternal Medicine Physician17723FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117723OTHERFLMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750887238
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY SULLIVAN DO
Provider Business Mailing Address
First Line : 100 S ASHLEY DR
Second Line : STE 600
City : TAMPA
State : FL
Zip : 33602-5300
Country : US
Telephone Number : 910-568-9297
Fax Number : 813-701-9323
Provider Business Practice Location Address
First Line : 100 S ASHLEY DR STE 600
Second Line :
City : TAMPA
State : FL
Zip : 33602-5300
Country : US
Telephone Number : 813-386-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2018
Last Update Date : 02/29/2024

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Directions to “ BRITTANY SULLIVAN DO” Practice Location

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