Nicole Elizabeth Avalon, P.A.-C
Physician Assistant, Medical in Jacksonville, FL. Individual provider (NPI-1).
NPI number1669601944
StatusActive
Last updated in NPPESAug 10, 2012
Details
- NPI
- 1669601944
- Entity type
- Individual (NPI-1)
- Name
- Nicole Elizabeth Avalon
- Credential
- P.A.-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2009
- Last updated
- Aug 10, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA9105027 | FL | Yes |
Other names
- Nicole Elizabeth Abong (Former Name)
Practice location
4500 San Pablo Rd SVas 550n
Jacksonville, FL 32224-1865
Phone 904-953-2000
Mailing address
4500 San Pablo Rd SVas 550n
Jacksonville, FL 32224-1865
Phone 904-953-2000
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