Sullivan, Brent C
Sullivan, Brent C is an individual health care provider with primary practice located at 14547 Bruce B Downs Blvd Suite D, Tampa FL 33613. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Sullivan, Brent C can be contacted via phone (813) 979-7733.Contact Information
Primary practice address
14547 Bruce B Downs Blvd Suite D
Tampa FL 33613
Phone: (813) 979-7733
Fax: (813) 355-5098
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ME69655 | Florida |
Profile Details
| NPI number | 1710098173 |
|---|---|
| LBN Legal business name | Sullivan, Brent C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Aug 27th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710098173 | NPPES |
| Florida | MEDICAID | 269015200 | |
| Florida | Other | P00085921 |
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