| Doctor Name: | DR. MARYELLEN SULLIVAN |
| NPI Number: | 1518027333 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, MS, DPT |
| License Number: | PT4152 |
| Business Practice Address: | 32672 Us 19 N Palm Harbor, FL - 34684 |
| Business Phone Number: | 7277722216 |
| Business Fax Number: | |
| Mailing Address: | 2781 Cottonwood Ct, CLEARWATER |
| State: | FL |
| Postal Code: | 337613809 |
| Phone Number: | 7277268627 |
| Fax Number: | |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT4152 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |