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General NPI Number Information
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NPI Number | 1972837938
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Entity Type | Individual
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Provider Name | JUAN FRANCISCO AVON CCPA
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Gender | Male
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 10000 SW 56TH ST SUITE 6
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City | MIAMI
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State | FL
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Zip | 33165-7165
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Country | US
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Telephone | 786-417-9932
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Fax | 305-279-4772
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Provider Business Mailing Address
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Address Line | 10000 SW 56 ST SUITE 6
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City | MIAMI
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State | FL
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Zip | 33165
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Country | US
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Telephone | 786-417-9932
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Fax | 305-279-4772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | CI473
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License Number State | FL
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