Provider Demographics
NPI:1417046160
Name:DUNBAR, LEVETTE NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:LEVETTE
Middle Name:NICOLE
Last Name:DUNBAR
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 1:15260 NW 147TH DR
Mailing Address - Street 2:STE 200
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-5339
Mailing Address - Country:US
Mailing Address - Phone:352-273-9120
Mailing Address - Fax:352-392-8725
Practice Address - Street 1:1702 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-5611
Practice Address - Country:US
Practice Address - Phone:855-577-5437
Practice Address - Fax:850-838-2140
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME913342080P0207X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278596000Medicaid
FLAII91YMedicare PIN