Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leia Sullivan, PAC

Individual provider Physician Assistant · NPI 1104679240

Leia Sullivan, PAC is a Physician Assistant in Fort Myers, Florida. Qualified in 2021, 5 years ago. Practices with Gastroenterology Associates of Southwest Florida LLC, a 61-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2024
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

4790 Barkley Cir Ste A
Fort Myers, FL 33907-7593
Phone: (239) 275-8882
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9118070 (FL)

Record details

NPI number1104679240
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorYes
NPI enumeratedApril 9, 2024
Last updated in NPPESApril 9, 2024
Certification dateApril 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Gastroenterology Associates Of Southwest Florida Llc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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