Provider Demographics
NPI:1760919211
Name:DUNES FAMILY CLINIC
Entity Type:Organization
Organization Name:DUNES FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBRIZ DE WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC
Authorized Official - Phone:877-880-7993
Mailing Address - Street 1:2052 BLARNEY STONE DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-7376
Mailing Address - Country:US
Mailing Address - Phone:877-880-7993
Mailing Address - Fax:877-880-7993
Practice Address - Street 1:2005 VALPARAISO ST STE 210
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3329
Practice Address - Country:US
Practice Address - Phone:219-841-6516
Practice Address - Fax:877-880-7993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care