Crystal F Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103646 Issued in FL

Practice address

3100 SW 62ND Ave
Miami, FL 33155-3009

Phone

(305) 666-6511

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1124256771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 SW 143RD TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331868397",
            "telephone_number": "305-971-2354",
            "fax_number": "305-971-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-666-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CRYSTAL",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suky Health Care Services, Inc.
• Leonardo Andres Sulbaran Sanchez
• Wendy E Sulc, M.D.
• Anuja Sule, MD
• Cailey Laura Sullivan, RBT
• John Edward Sullivan, M.D.
• Leanna Elizabeth Sullivan, PA-C
• Rhona W Sullivan, PTA
• Rosemary Irene Sullivan, L.C.S.W.
• Sultan Sol, LLC

• Physician Assistant in Miami, FL
• Providers in Miami, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.