Healthcare Provider Details

I. General information

NPI: 1417046160
Provider Name (Legal Business Name): LEVETTE NICOLE DUNBAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 S JEFFERSON ST
PERRY FL
32348-5611
US

IV. Provider business mailing address

15260 NW 147TH DR STE 200
ALACHUA FL
32615-5339
US

V. Phone/Fax

Practice location:
  • Phone: 855-577-5437
  • Fax: 850-838-2140
Mailing address:
  • Phone: 352-273-9120
  • Fax: 352-392-8725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME91334
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME91334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: