MEDICARE: DR. ELISABETH PETIT-FOND APONTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	59856	MN
2	202D00000X	Integrative Medicine Physician	0007116	MN

General Provider Information

NPI Number	:	1871725986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISABETH PETIT-FOND APONTE M.D.

Provider Business Mailing Address
First Line	:	1702 MILLER TRUNK HWY STE 206
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-4448
Country	:	US
Telephone Number	:	218-517-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 MILLER TRUNK HWY STE 206
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-4448
Country	:	US
Telephone Number	:	216-517-5151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2009
Last Update Date	:	03/19/2026

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