Provider Demographics
NPI:1972837938
Name:AVON, JUAN FRANCISCO (CCPA)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:FRANCISCO
Last Name:AVON
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Gender:M
Credentials:CCPA
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Mailing Address - Street 1:10000 SW 56 ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165
Mailing Address - Country:US
Mailing Address - Phone:786-417-9932
Mailing Address - Fax:305-279-4772
Practice Address - Street 1:10000 SW 56TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7165
Practice Address - Country:US
Practice Address - Phone:786-417-9932
Practice Address - Fax:305-279-4772
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
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Provider Licenses
StateLicense IDTaxonomies
FLCI473363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant