Provider Demographics
NPI:1104897321
Name:DUNKELBERGER, SHERRI (DO)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:DUNKELBERGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 JUNGLE AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-4308
Mailing Address - Country:US
Mailing Address - Phone:727-341-0873
Mailing Address - Fax:
Practice Address - Street 1:6801 GULFPORT BLVD S
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-2127
Practice Address - Country:US
Practice Address - Phone:727-592-1919
Practice Address - Fax:727-800-6989
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS9215OtherFLORIDA STATE LICENSE