Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME137915 | FL |
N | 208600000X | Surgeon | ME137915 | FL |
Y | 2086S0102X | Surgical Critical Care | ME137915 | FL |
N | 2086S0127X | Trauma Surgeon | 59045 | AZ |
N | 2086S0127X | Trauma Surgeon | ME137915 | FL |
NPI | 1164765731 |
---|---|
Provider Name | Dr. Tony Dunne |
First Address | Phoenix, AZ 85032-3354 |
Second Address | Melbourne, FL 32901-3224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2013 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102447300 | (05) | FL |
555384 | (05) | AZ |
LV391 | MEDICARE (01) | FL |
LV417 | MEDICARE (01) | FL |