MEDICARE: DUNSTAN M HENRY APRN, AGNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	APRN11034444	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APRN110034444	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1043917982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUNSTAN M HENRY APRN, AGNP-C

Provider Business Mailing Address
First Line	:	3042 N FEDERAL HWY STE 305
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1400
Country	:	US
Telephone Number	:	561-984-1300
Fax Number	:	561-288-0830

Provider Business Practice Location Address
First Line	:	3042 N FEDERAL HWY STE 305
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1400
Country	:	US
Telephone Number	:	561-984-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	12/08/2025

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