Basic Information
| Provider Information | |||||||||
| NPI: | 1033181490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'SULLIVAN | ||||||||
| FirstName: | SHAUNA | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | NAS JACKSONVILLE | ||||||||
| Address2: | BUILDING 554 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579537550 | ||||||||
| FaxNumber: | 7579530090 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 BOB WILSON DR | ||||||||
| Address2: | NMCSD SUITE 300 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921343300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195325200 | ||||||||
| FaxNumber: | 6195327508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2006 | ||||||||
| LastUpdateDate: | 10/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 02002814A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.