Most Relevant Information
Provider Data
| NPI Number: | 1003255761 |
| Provider Name: | NATALIE KETSIA ALPHONSE SULLIVAN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/17/2013 |
| Last Updated: | 12/18/2020 |
Provider Practice Location
901 TAMIAMI TRL S
VENICE
FL
342853668
Practice Location Phone/Fax
| Phone: | 9414858455 |
| Fax: |
Provider Mailing Location
501 KNIGHTS RUN AVE APT 1130
TAMPA
FL
336025943
Provider Mailing Phone/Fax
| Phone: | 8505591100 |
| Fax: |