Provider Demographics
NPI:1528072592
Name:ASSOCIATES IN GYNECOLOGY AND OBSTETRICS, PA
Entity type:Organization
Organization Name:ASSOCIATES IN GYNECOLOGY AND OBSTETRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:941-955-8076
Mailing Address - Street 1:2439 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6304
Mailing Address - Country:US
Mailing Address - Phone:941-955-8076
Mailing Address - Fax:941-955-0453
Practice Address - Street 1:2439 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6304
Practice Address - Country:US
Practice Address - Phone:941-955-8076
Practice Address - Fax:941-955-0453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43835207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24195OtherBCBS
FL24195OtherBCBS