Lisa Sullivan, Md S.C. in Lutz - Medical Specialty
Lisa Sullivan, Md S.C. - NPI 1790949980
Lisa Sullivan, Md S.C. is a Medical Specialty in Lutz, Florida. Lisa Sullivan, Md S.C. practices all healthcare services and medical treatments related to Medical Specialty. The NPI Number for Lisa Sullivan, Md S.C. is 1790949980. The last update date is 2021-08-10.
Lisa Sullivan, Md S.C.'s current location address is 4604 Cheval Blvd, Lutz, Florida. You can contact this provider via phone number 8478058088 and fax number 8478058844. The mailing address for Lisa Sullivan, Md S.C. is 4604 Cheval Blvd, Lutz, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lisa Sullivan, Md S.C. |
|---|---|
| Address | 4604 Cheval Blvd, Lutz, Florida |
| Phone Number | 8478058088 |
| Fax Number | 8478058844 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Sullivan Marie Lisa |
| Credentials | MD |
| Telephone Number | 8478058088 |
NPI Number Detail
| NPI Number | 1790949980 |
|---|---|
| Provider Enumeration Date | 2008-07-16 |
| Last Updated Date | 2021-08-10 |
Provider Mailing Address Detail
| Address | 4604 Cheval Blvd |
|---|---|
| City | Lutz |
| State | Florida (FL) |
| Post Code | 335585343 |
| Phone Number | 8478058088 |
| Fax Number | 8478058844 |
Provider's Primary Taxonomy Detail
| Speciality | Medical Specialty |
|---|---|
| Taxonomy | 261Qm2500X |
| Licence No | 36107599 |
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Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific |
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What is the unique 10-digit identification code assigned to Lisa Sullivan, Md S.C. by the Centers for Medicare & Medicaid Services?
The Lisa Sullivan, Md S.C. has been issued the NPI (National Provider Identifier) 1790949980, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Lisa Sullivan, Md S.C.?
The Lisa Sullivan, Md S.C. is physically situated at 4604 Cheval Blvd, in the city of Lutz, state of FL, with the postal code 335585343.
What is Lisa Sullivan, Md S.C.'s specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Lisa Sullivan, Md S.C. is Medical Specialty, and the taxonomy code that classifies this field of practice is 261Qm2500X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1790949980 to Lisa Sullivan, Md S.C.?
The Centers for Medicare & Medicaid Services originally issued the 1790949980 to Lisa Sullivan, Md S.C. on 2008-07-16.
When was the Lisa Sullivan, Md S.C.'s information last updated?
The Lisa Sullivan, Md S.C.'s information was last updated on 2021-08-10.
NPI Number: 1063415297
Address: 510 Spring St, Jeffersonville, IN