Provider Demographics
NPI:1275068769
Name:DUNN, MAIA (ATC)
Entity Type:Individual
Prefix:
First Name:MAIA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9673 BAY HARBOR CIR
Mailing Address - Street 2:APT 204
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-5721
Mailing Address - Country:US
Mailing Address - Phone:407-922-1678
Mailing Address - Fax:
Practice Address - Street 1:9673 BAY HARBOR CIR
Practice Address - Street 2:APT 204
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-5721
Practice Address - Country:US
Practice Address - Phone:407-922-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program