Healthcare Provider Details

I. General information

NPI: 1760477442
Provider Name (Legal Business Name): MICHAEL E DUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 W GANDY BLVD
TAMPA FL
33611-2931
US

IV. Provider business mailing address

3317 W GANDY BLVD
TAMPA FL
33611-2931
US

V. Phone/Fax

Practice location:
  • Phone: 813-902-8600
  • Fax: 813-902-8800
Mailing address:
  • Phone: 813-902-8600
  • Fax: 813-902-8800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME0066704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: