Jonathan M Sullivan, D.P.M. Valid NPI

Individual provider · Foot & Ankle Surgery Podiatrist · Palm Coast, FL

NPI

1528387958

Type

Individual (Type 1)

Primary specialty

Foot & Ankle Surgery Podiatrist (Podiatrist)

Specialty group

Podiatric Medicine & Surgery Service Providers

Taxonomy code

213ES0103X

License number

36003666 (OH)

Sex

Male

Sole proprietor

Yes

Enumerated

2010-05-25

Last updated

2021-03-31