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Individual
WILLIAM MARK AVONDA
Active
Individual
WILLIAM MARK AVONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OB3177
FL
152W00000X
Optometrist
Primary
OPC3868
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001933700
—
FL
01
—
1180560001
MEDICARE DMERC
—
01
—
25000
BLUE CROSS BLUE SHIELD
FL
01
—
297390
AVMED
FL
05
—
620978500
—
FL
05
—
620978501
—
FL
01
—
7155780
AETNA
FL
01
—
P00208868
RAILROAD MEDICARE
—
Enumeration date
07/07/2006
Last updated
03/21/2011
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