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

Mr. Samuel Alan Sullivan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1295538106

Mr. Samuel Alan Sullivan is a Student in an Organized Health Care Education/Training Program in Fort Walton Beach, Florida. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone: (217) 274-0529
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1295538106
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 28, 2025
Last updated in NPPESMarch 28, 2025
Certification dateMarch 28, 2025
Mailing address1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708

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