Individual provider Active NPI

Alonso Avendano, PA-C

  • Physician Assistant
  • Ocala, FL
National Provider Identifier
1043243298
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9103784 Issued in FL
Practice address
1500 SE 17TH St Ste 600
Ocala, FL 34471-4630
Phone
(352) 732-8955
Fax
(352) 732-7999
NPI assigned
Jul 9, 2006
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9103784 FL Primary

Addresses

Primary practice location

1500 SE 17TH St Ste 600
Ocala, FL 34471-4630

Mailing address

1500 SE 17TH St Ste 600
Ocala, FL 34471-4630
Phone (352) 732-8955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200325003671 FL Practitioner - Physician Assistant 2466532775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Apr 1, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Apr 1, 2020 Accepting new patients
Acute Care Pediatrics of Palm Coast, PA Past Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1500 SE 17th St
Ste 600
Ocala, FL 34471
Phone (352) 273-7770

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1043243298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 SE 17TH ST STE 600",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714630",
            "telephone_number": "352-732-8955",
            "fax_number": "352-732-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SE 17TH ST STE 600",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714630",
            "telephone_number": "352-732-8955",
            "fax_number": "352-732-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENDANO",
        "first_name": "ALONSO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.