Provider Demographics
NPI:1568447761
Name:APONTE, DAVID (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:APONTE
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-7380
Mailing Address - Country:US
Mailing Address - Phone:850-398-8480
Mailing Address - Fax:850-398-8482
Practice Address - Street 1:710 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-7380
Practice Address - Country:US
Practice Address - Phone:850-398-8480
Practice Address - Fax:850-398-8482
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1034917363AS0400X
FLPA9104979363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCA600ZMedicare PIN