Provider Demographics
NPI:1316006703
Name:DUNKIN, GLORIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:E
Last Name:DUNKIN
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 1:6231 P G A BLVD
Mailing Address - Street 2:SUITE 104 - #277
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4033
Mailing Address - Country:US
Mailing Address - Phone:561-352-3591
Mailing Address - Fax:561-624-1325
Practice Address - Street 1:2201 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2047
Practice Address - Country:US
Practice Address - Phone:561-842-6141
Practice Address - Fax:561-881-4364
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME843902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265346000Medicaid
FL81000OtherBCBS
FLK6339Medicare ID - Type Unspecified