Provider Demographics
NPI:1538972112
Name:DUNN, BRYANT DANIEL
Entity type:Individual
Prefix:
First Name:BRYANT
Middle Name:DANIEL
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HAZEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-7413
Mailing Address - Country:US
Mailing Address - Phone:407-417-7366
Mailing Address - Fax:
Practice Address - Street 1:109 HAZEL BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-7413
Practice Address - Country:US
Practice Address - Phone:407-417-7366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program