Sara Sullivan, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL2962 Issued in FL

Practice address

4450 E Fletcher Ave Ste C
Tampa, FL 33613-4907

Phone

(813) 540-4777

Fax

(813) 336-2112

NPI assigned

Jan 24, 2014

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1225451347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 NURSERY RD APT 41-203",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337647656",
            "telephone_number": "727-484-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 E FLETCHER AVE STE C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134907",
            "telephone_number": "813-540-4777",
            "fax_number": "813-336-2112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Phillies Dr",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337554337",
            "country_code": "US",
            "telephone_number": "727-797-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SARA",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Sullivan, ARNP
• Lisa Otero Sullivan, MA, LMFT
• Megan Catherine Sullivan, AU.D.
• Miranda Christine Sullivan, MD
• Ryan Sullivan
• Wendy Sullivan
• Roy Frank Sulma, OTR/L
• Reshma Sulthana
• Andrew Sultzbaugh, MD
• Sue Jean Sultzer, LMT

• Athletic Trainer in Tampa, FL
• Providers in Tampa, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.