Healthcare Provider Details

I. General information

NPI: 1871725986
Provider Name (Legal Business Name): ELISABETH PETIT-FOND APONTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. ELISABETH PETIT-FOND

II. Dates (important events)

Enumeration Date: 08/23/2009
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 MILLER TRUNK HWY STE 206
DULUTH MN
55811-4448
US

IV. Provider business mailing address

1702 MILLER TRUNK HWY STE 206
DULUTH MN
55811-4448
US

V. Phone/Fax

Practice location:
  • Phone: 216-517-5151
  • Fax:
Mailing address:
  • Phone: 218-517-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number59856
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number0007116
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: