Provider Demographics
NPI:1629005020
Name:AVERILL, FRANCIS J (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:J
Last Name:AVERILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2103
Mailing Address - Country:US
Mailing Address - Phone:727-447-3000
Mailing Address - Fax:
Practice Address - Street 1:802 N BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2103
Practice Address - Country:US
Practice Address - Phone:727-447-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60749207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
14504ZMedicare ID - Type Unspecified
E57461Medicare UPIN