Provider Demographics
NPI:1093113391
Name:DUNN, LANA (PHARM D)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19390 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-3041
Mailing Address - Country:US
Mailing Address - Phone:352-750-2714
Mailing Address - Fax:352-205-4738
Practice Address - Street 1:19390 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3041
Practice Address - Country:US
Practice Address - Phone:352-750-2714
Practice Address - Fax:352-205-4738
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36015183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist