Basic Information
Provider Information
NPI: 1942566526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNN
FirstName: JONATHAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 COMMUNITY DR
Address2:  
City: MANHASSET
State: NY
PostalCode: 110303816
CountryCode: US
TelephoneNumber: 5165622342
FaxNumber: 2155037007
Practice Location
Address1: 6200 SUNSET DR STE 401
Address2:  
City: SOUTH MIAMI
State: FL
PostalCode: 331434829
CountryCode: US
TelephoneNumber: 3056664633
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/08/2012
LastUpdateDate: 04/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X282600-1NYN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0000XME136855FLY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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