DR. JOSEPH WYNN SULLIVAN (NPI# 1982691689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982691689 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH WYNN SULLIVAN |
| Credential | D.O. |
| Practice Address |
600 Zeagler Dr Palatka FL 32177-3811 |
| Mailing Address |
4371 Veronica S Shoemaker Blvd Fort Myers FL 33916-2216 |
| Practice Telephone | 3863258140 |
| Practice Fax Number | 3863258848 |
| Mailing Telephone | 2392748200 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2018-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
OS 5691 | FL | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
OS5691 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | WELLCARE | 1193481 | 01 |
| FL | BCBS | 80404 | 01 |
| FL | 064451000 | 05 | |
| FL | WELLCARE | 196724 | 01 |
| FL | AETNA | 4473165 | 01 |
| FL | RR MEDICARE | P01593279 | 01 |
| FL | BCBS | 1679440 | 01 |
| FL | RR MEDICARE | P01327657 | 01 |
| FL | AETNA | 4663165 | 01 |
| FL | AVMED | 208804 | 01 |
| FL | FLORIDA HEALTHCARE PLUS | P0026501 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104107903 | Joseph Vincent Sullivan | Dentist | 9221 Sandifur Pkwy, Suite B, Pasco, WA 99301-9241 | 2011-09-07 |
| 1427296375 | Joseph M. Sullivan | Podiatrist | 2144 Capewood Dr, Huddleston, VA 24104-3430 | 2009-01-30 |
| 1578642138 | Joseph C Sullivan IIi | Chiropractor | 17 Leonard St, Smithtown, NY 11787-1015 | 2006-11-03 |
| 1063526325 | Joseph David Sullivan | Counselor | 1701 Centerview Dr Ste 102, Little Rock, AR 72211-4311 | 2006-08-17 |
| 1518953710 | Joseph Brian Sullivan | Internal Medicine | 620 Washington St, Suite A, Franklin, MA 02038-3300 | 2005-09-22 |
| 1255326690 | Joseph B. Sullivan | Optometrist | 8118 E Douglas Ave, Suite 107, Wichita, KS 67206-2364 | 2005-09-13 |
| 1336682418 | Joseph Sullivan | Chiropractor | 10160 W 50th Ave, Ste 4, Wheat Ridge, CO 80033-2339 | 2016-11-22 |
| 1437497856 | Joseph Sullivan | Rehabilitation Counselor | 895 Roberta Ln, Suite 101, Sparks, NV 89431-6802 | 2013-01-18 |
| 1295022903 | Joseph Sullivan | Surgery | 2000 E Layton Ave, St Francis, WI 53235-6053 | 2011-07-01 |
| 1881909836 | Joseph Andrew Sullivan | Case Manager/Care Coordinator | 1500 Ne Irving St, Portland, OR 97232-2243 | 2010-08-15 |
| Street Address |
600 ZEAGLER DR |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689189391 | Florida Cancer Specialists & Research Institute, LLC | Internal Medicine | 600 Zeagler Dr, Palatka, FL 32177-3811 | 2017-12-05 |
| 1275057994 | Putnam Radiation Oncology LLC | Radiology | 600 Zeagler Dr, Palatka, FL 32177-3811 | 2017-08-03 |
| 1518986926 | Integrated Community Oncology Network LLC | Radiology | 600 Zeagler Dr, Suite 2, Palatka, FL 32177-3811 | 2006-07-18 |
| 1740246974 | Anand Mathai Kuruvilla | Specialist | 600 Zeagler Dr, Suite 2, Palatka, FL 32177-3811 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194343210 | Jayaben Patel | Internal Medicine | 11818 Shire Wycliffe Ct, Tampa, FL 33626-3329 | 2020-07-07 |
| 1922628833 | Heme Onc Call, LLC | Internal Medicine | 5825 Sw 117th St, Pinecrest, FL 33156-5007 | 2020-04-21 |
| 1457851552 | Yvette M Herrington | Internal Medicine | 425 S Parsons Ave Ste 101, Brandon, FL 33511-5290 | 2018-02-15 |
| 1104360221 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 658 Oviedo Medical Drive, Oviedo, FL 32765 | 2016-12-08 |
| 1225424369 | Florence Arnold | Internal Medicine | 3830 Bee Ridge Rd Ste 301, Sarasota, FL 34233 | 2015-04-15 |
| 1073901187 | Edward Mcaloon | Internal Medicine | 108 Homeport Dr, Palm Harbor, FL 34683-5409 | 2014-12-26 |
| 1063818235 | Barry M. Krein | Internal Medicine | 4220 Careywood Dr, Melbourne, FL 32934-7679 | 2014-11-14 |
| 1912311630 | David Longacre | Internal Medicine | 2439 Weymouth Dr, Clearwater, FL 33764-6556 | 2014-06-20 |
| 1508270778 | Gerard Chaaya | Internal Medicine | 4306 Alton Rd Fl 3, Miami Beach, FL 33140-2840 | 2014-06-16 |
| 1982026670 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 2100 W 1st St, Sanford, FL 32771-1603 | 2014-01-14 |
| Find all providers with the same taxonomy | ||||
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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.