Provider Demographics
NPI:1073735270
Name:DUNN, INGRID PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:PATRICIA
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 AVALON PARK WEST BLVD
Mailing Address - Street 2:SUITE #230
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7303
Mailing Address - Country:US
Mailing Address - Phone:407-453-2072
Mailing Address - Fax:407-601-1053
Practice Address - Street 1:3701 AVALON PARK WEST BLVD
Practice Address - Street 2:SUITE #230
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7303
Practice Address - Country:US
Practice Address - Phone:407-453-2072
Practice Address - Fax:407-601-1053
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 104799207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCX948YOtherMEDICARE PTAN
FLCX949AOtherMEDICARE PTAN
FL001933000Medicaid
FL002284400Medicaid