Provider Demographics
NPI:1073604708
Name:AVRIL, LEONARD F (OD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:F
Last Name:AVRIL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 SANTA BARBARA BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-4318
Mailing Address - Country:US
Mailing Address - Phone:239-574-5406
Mailing Address - Fax:239-574-9212
Practice Address - Street 1:2221 SANTA BARBARA BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-4318
Practice Address - Country:US
Practice Address - Phone:239-574-5406
Practice Address - Fax:239-574-9212
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2161152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620010900Medicaid
FL19508Medicare PIN
FLU17887Medicare UPIN