Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 02002814A | IN |
NPI | 1033181490 |
---|---|
Provider Name | Dr. Shauna Frances O'sullivan |
First Address | Jacksonville, FL 32212 |
Second Address | San Diego, CA 92134-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 20/10/2016 |