Provider Demographics
NPI:1962476044
Name:DUNN, JOHANNE SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:JOHANNE
Middle Name:SCOTT
Last Name:DUNN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOHANNE
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:339 CYPRESS PKWY STE 180
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3329
Mailing Address - Country:US
Mailing Address - Phone:407-502-2300
Mailing Address - Fax:321-697-0089
Practice Address - Street 1:339 CYPRESS PKWY STE 180
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3329
Practice Address - Country:US
Practice Address - Phone:407-502-2300
Practice Address - Fax:321-697-0089
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251972100Medicaid
FL251972100Medicaid
FL28208XMedicare PIN