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General NPI Number Information
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NPI Number | 1861861627
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Entity Type | Organization
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Legal Business Name | ALACHUA FAMILY EYE CARE, PA
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 16181 NW US HIGHWAY 441 STE 140
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City | ALACHUA
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State | FL
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Zip | 32615-6578
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Country | US
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Telephone | 352-792-1610
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Fax |
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Provider Business Mailing Address
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Address Line | 16181 NW US HIGHWAY 441 STE 140
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City | ALACHUA
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State | FL
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Zip | 32615-6578
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Country | US
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Telephone | 352-792-1610
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | DR. WILLIAM MARK AVONDA
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Credential | O.D.
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Telephone | 352-792-1610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3868
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License Number State | FL
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