BRENT C SULLIVAN (NPI# 1710098173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710098173 |
| Entity Type | Individual |
| Full Name | BRENT C SULLIVAN |
| Credential | MD |
| Practice Address |
14547 Bruce B Downs Blvd Suite D Tampa FL 33613 |
| Mailing Address |
38135 Market Square Zephyrhills FL 33542 |
| Practice Telephone | 8139797733 |
| Practice Fax Number | 8133555098 |
| Mailing Telephone | 8135284975 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME69655 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | P00085921 | 01 |
| FL | 269015200 | 05 |
| Street Address |
14547 BRUCE B DOWNS BLVD SUITE D |
| City | TAMPA |
| State | FL |
| Zip Code | 33613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538156591 | Wendy Ann Whitford | Nurse Anesthetist, Certified Registered | 14547 Bruce B Downs Blvd, Tampa, FL 33613-2709 | 2005-10-04 |
| 1972020527 | Boris Borissov | Nurse Practitioner | 14547 Bruce B Downs Blvd, Tampa, FL 33613-2709 | 2017-08-24 |
| 1740667187 | Florida Medical Clinic, LLC | Clinic/Center | 14547 Bruce B Downs Blvd, Suite C, Tampa, FL 33613-2709 | 2015-05-06 |
| 1902295009 | North Pinellas Anesthesia Asscoiates Pa | Anesthesiology | 14547 Bruce B Downs Blvd, Tampa, FL 33613-2709 | 2015-01-13 |
| 1639575079 | Brittany Loringer | Physician Assistant | 14547 Bruce B Downs Blvd, Ste. C, Tampa, FL 33613-2709 | 2014-11-12 |
| 1861732182 | Sherdene Barrett | Nurse Practitioner | 14547 Bruce B Downs Blvd, Ste D, Tampa, FL 33613-2709 | 2013-02-22 |
| 1548518780 | Christopher R Smith | Physician Assistant | 14547 Bruce B Downs Blvd, Suite C, Tampa, FL 33613-2709 | 2012-08-20 |
| 1154610616 | Florida Medical Clinic, LLC | Durable Medical Equipment & Medical Supplies | 14547 Bruce B Downs Blvd, Suite C, Tampa, FL 33613-2709 | 2011-04-05 |
| 1720385438 | Kimberly Myers Cudzil | Nurse Practitioner | 14547 Bruce B Downs Blvd, Suite C, Tampa, FL 33613-2709 | 2011-02-15 |
| 1659535789 | Josh Gilliam | Physician Assistant | 14547 Bruce B Downs Blvd, Tampa, FL 33613-2709 | 2008-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124468632 | Raul E. Fernandez-crespo | Urology | 2 Tampa General Circle, Stc6, Department of Urology, Tampa, FL 33606 | 2013-06-28 |
| 1013208057 | Mohit Sirohi | Urology | 1 Davis Blvd., #604, Tampa, FL 33606 | 2011-04-25 |
| 1629170535 | James Etheridge | Urology | 17718 Esprit Dr, Tampa, FL 33647-2507 | 2006-09-01 |
| 1669481628 | Raoul Radu Salup | Urology | 13000 Bruce B Downs Boulevard, James A. Haley Veterans Hospital, Tampa, FL 33612 | 2006-08-07 |
| 1003840091 | New Tampa Urology P A | Urology | 5332 Primrose Lake Cir, Tampa, FL 33647-3589 | 2006-07-10 |
| 1588695894 | Rafael E Carrion | Urology | 2 Tampa General Circle, Stc 5th Floor, Tampa, FL 33606-3603 | 2006-07-05 |
| 1205872710 | Tampa Urology Pa | Urology | 1209 W Swann Ave, Tampa, FL 33606-2639 | 2006-06-22 |
| 1245275692 | Leffie Mahon Carlton IIi | Urology | 602 S Audubon Street, Tampa, FL 33609 | 2006-06-19 |
| 1043269970 | Tod Joseph Fusia | Urology | 2822 W Virginia Ave, Tampa, FL 33607-6330 | 2006-05-08 |
| 1760457220 | Novelle Dt Kirwan | Urology | 4801 N Howard Ave, Tampa, FL 33603-1411 | 2006-02-20 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.