Provider Demographics
NPI:1639328396
Name:ROBERT PAUL DUNNE DPM PA
Entity Type:Organization
Organization Name:ROBERT PAUL DUNNE DPM PA
Other - Org Name:LAKE WASHINGTON FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-253-6191
Mailing Address - Street 1:2717 N. WICKHAM RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-253-6191
Mailing Address - Fax:321-253-6194
Practice Address - Street 1:2717 N. WICKHAM RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-253-6191
Practice Address - Fax:321-253-6194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2287213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU40950Medicare UPIN
U40950Medicare UPIN
FLDQ128AMedicare PIN
FL0883190001Medicare NSC