Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | POR248 | FL |
N | 222Z00000X | Podiatrist | POR248 | FL |
Y | 224P00000X | Prosthetist | POR248 | FL |
NPI | 1326471236 |
---|---|
Provider Name | Keven Dunn |
First Address | Gainesville, FL 32608-1135 |
Second Address | Gainesville, FL 32608-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
952053800 | (05) | FL |