Healthcare Provider Details

I. General information

NPI: 1437075694
Provider Name (Legal Business Name): ERALD PACIO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 28307 MEDDAC-B BUILDING 700, ROOM 109
APO AE
09112
US

IV. Provider business mailing address

UNIT 28307 MEDDAC-B BUILDING 700, ROOM 109
APO AE
09112-8037
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN233373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: