Individual
ANSEL AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5999 NORMANDY BLVD, JACKSONVILLE, FL 32205-6265
(904) 786-2148
Mailing address
159 SENTOSA DR UNIT 207, ST JOHNS, FL 32259-9192
(714) 876-8423
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS61242
FL
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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