Provider Demographics
NPI:1861861627
Name:ALACHUA FAMILY EYE CARE, PA
Entity Type:Organization
Organization Name:ALACHUA FAMILY EYE CARE, PA
Other - Org Name:ALACHUA FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:AVONDA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:352-792-1610
Mailing Address - Street 1:16181 NW US HIGHWAY 441
Mailing Address - Street 2:STE 140
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-6578
Mailing Address - Country:US
Mailing Address - Phone:352-792-1610
Mailing Address - Fax:
Practice Address - Street 1:16181 NW US HIGHWAY 441
Practice Address - Street 2:STE 140
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-6578
Practice Address - Country:US
Practice Address - Phone:352-792-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3868152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty