Provider Demographics
NPI:1285021725
Name:DUNLEAVY, SEAN EDWARD (DPM)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:EDWARD
Last Name:DUNLEAVY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6331 ROYAL WOODS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-6141
Mailing Address - Country:US
Mailing Address - Phone:844-903-1187
Mailing Address - Fax:
Practice Address - Street 1:730 GOODLETTE RD N STE 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5617
Practice Address - Country:US
Practice Address - Phone:239-430-3668
Practice Address - Fax:239-692-9573
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006660213ES0103X
FLPO3981213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery