Healthcare Provider Details

I. General information

NPI: 1073735270
Provider Name (Legal Business Name): INGRID PATRICIA DUNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 AVALON PARK WEST BLVD SUITE #230
ORLANDO FL
32828-7303
US

IV. Provider business mailing address

3701 AVALON PARK WEST BLVD SUITE #230
ORLANDO FL
32828-7303
US

V. Phone/Fax

Practice location:
  • Phone: 407-453-2072
  • Fax: 407-601-1053
Mailing address:
  • Phone: 407-453-2072
  • Fax: 407-601-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME 104799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: