| Entity Name: | JOHN E SULLIVAN MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Jan 2012 (13 years ago) |
| Document Number: | P12000006785 |
| FEI/EIN Number | 37-1663906 |
| Address: | 800 meadows road, boca raton, FL, 33486, US |
| Mail Address: | 800 meadows road, boca raton, FL, 33486, US |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134458839 | 2009-12-09 | 2009-12-09 | 1880 ARLINGTON ST, SUITE 203, SARASOTA, FL, 342393518, US | 1880 ARLINGTON ST, SUITE 203, SARASOTA, FL, 342393524, US | |||||||||||||||||||||
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| Phone | +1 941-365-2918 |
| Fax | 9413661658 |
Authorized person
| Name | DR. JOHN EDWIN SULLIVAN |
| Role | PRESIDENT |
| Phone | 9413652918 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 045524500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MICHAEL A CECERE PA | Agent | 945-A CLINT MOORE ROAD, BOCA RATON, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| SULLIVAN JOHN E | President | 800 meadows road, boca raton, FL, 33486 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-20 | 800 meadows road, boca raton, FL 33486 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-20 | 800 meadows road, boca raton, FL 33486 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-01-20 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
