Provider Demographics
NPI:1871319798
Name:MULROY, DINA CARLETT MARIE (PHYSICIAN ASSISTANT)
Entity type:Individual
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First Name:DINA
Middle Name:CARLETT MARIE
Last Name:MULROY
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Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:17035 HAMPTON FALLS TER
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-2603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17035 HAMPTON FALLS TER
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-2603
Practice Address - Country:US
Practice Address - Phone:201-693-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant