Healthcare Provider Details

I. General information

NPI: 1235469602
Provider Name (Legal Business Name): CHRISTINA MICHAEL DUNN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2010
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16521 S US HIGHWAY 301
WIMAUMA FL
33598-2032
US

IV. Provider business mailing address

16521 S US HIGHWAY 301
WIMAUMA FL
33598-2032
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-4700
  • Fax:
Mailing address:
  • Phone: 813-844-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9111009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: