MR. Samuel Alan Sullivan
NPI #1295538106 in Fort Walton Beach, Florida
Provider Information
- NPI Number
- 1295538106
- Entity Type
- Individual
- Name
- MR. Samuel Alan Sullivan
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- Mar 28, 2025
- Last Updated
- Mar 28, 2025
Practice Location
- Address
- 1000 MAR WALT DR
- State
- Florida
- ZIP Code
- 32547-6708
- Phone
- (217) 274-0529
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
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