Individual
MARTIN E AVALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8725 N WICKHAM RD, SUITE 302, MELBOURNE, FL 32940-5997
(321) 434-9230
(321) 434-9231
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 434-4600
(321) 434-4662
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME79783
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258475100
—
FL
Enumeration date
08/17/2005
Last updated
06/22/2011
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