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1508600859
SAMANTHA JANE SULLIVAN
GAINESVILLE, FL
NPI
1508600859
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Former Name
SAMANTHA JANE AVALOS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL 11033413)
Enumeration Date
2024-06-21
Last Update Date
2024-12-12
Business Address
SAMANTHA JANE SULLIVAN APRN
1600 SW ARCHER RD
GAINESVILLE, FL 32610-3001
Phone number: 352-273-9079
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Mailing Address
SAMANTHA JANE SULLIVAN APRN
PO BOX 100288
GAINESVILLE, FL 32610-0277
Phone number: 352-273-9079
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