Provider Demographics
NPI:1457443806
Name:AVELLINA, FRANCESCA FELICE (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANCESCA
Middle Name:FELICE
Last Name:AVELLINA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BOONE RD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1894
Mailing Address - Country:US
Mailing Address - Phone:360-476-1714
Mailing Address - Fax:360-476-2480
Practice Address - Street 1:1400 FARRAGUT AVE BLDG 940
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98314-6001
Practice Address - Country:US
Practice Address - Phone:360-476-1714
Practice Address - Fax:360-476-2480
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-09-17
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-02-25
Provider Licenses
StateLicense IDTaxonomies
CA7915T152W00000X
CO2794152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10620Medicare UPIN