Healthcare Provider Details

I. General information

NPI: 1982652160
Provider Name (Legal Business Name): PHILIP H. DUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE SUITE 381
ORLANDO FL
32804-4623
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD ATTN: CREDENTIALING DEPARTMENT
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-5452
  • Fax: 407-894-1183
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME0037819
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: