| Doctor Name: | MR. ALONSO AVENDANO |
| NPI Number: | 1043243298 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PAT 9103784 |
| Business Practice Address: | 397 Palm Coast Pkwy Sw Unit 303 Palm Coast, FL - 321374776 |
| Business Phone Number: | 3864477337 |
| Business Fax Number: | 3864477348 |
| Mailing Address: | 397 Palm Coast Pkwy Sw Unit 303, PALM COAST |
| State: | FL |
| Postal Code: | 321374776 |
| Phone Number: | 3864477337 |
| Fax Number: | 3864477348 |
| NPI Enumeration Date: | 07/09/2006 |
| NPI Last Update Date: | 02/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PAT 9103784 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |