Provider Demographics
NPI:1871725986
Name:APONTE, ELISABETH PETIT-FOND (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:PETIT-FOND
Last Name:APONTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:PETIT-FOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4106 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3020
Mailing Address - Country:US
Mailing Address - Phone:218-517-5151
Mailing Address - Fax:
Practice Address - Street 1:4106 9TH AVE W
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3020
Practice Address - Country:US
Practice Address - Phone:218-517-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-23
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59856207W00000X
IA40936207W00000X
FLME119074207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME119074OtherFL LICENSE