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Individual

EDEN AVNI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
950 S PINE ISLAND RD STE A-180, PLANTATION, FL 33324
(954) 587-4218
(954) 587-4219
Mailing address
950 S PINE ISLAND RD STE A-180, PLANTATION, FL 33324-3918
(954) 587-4218
(954) 587-4219

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110714
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
FL
Enumeration date
11/14/2017
Last updated
11/13/2018
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