MEDICARE: DR. FREDDY AVNI 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	207R00000X	Internal Medicine Physician	ME00068307	FL
2	207RR0500X	Rheumatology Physician	ME68307	FL

General Provider Information

NPI Number	:	1972706729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDDY AVNI M.D.

Provider Business Mailing Address
First Line	:	1395 S STATE ROAD 7 STE 420
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-9327
Country	:	US
Telephone Number	:	561-204-4687
Fax Number	:	561-204-4694

Provider Business Practice Location Address
First Line	:	1395 S STATE ROAD 7 STE 420
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-9327
Country	:	US
Telephone Number	:	561-204-4687
Fax Number	:	561-204-4694

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	02/10/2017

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