Healthcare Provider Details

I. General information

NPI: 1790759397
Provider Name (Legal Business Name): FLORENCIO E YUZON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 KOLBE RD SUITE 106
LORAIN OH
44053-1654
US

IV. Provider business mailing address

PO BOX 636643
CINCINNATI OH
45263-6643
US

V. Phone/Fax

Practice location:
  • Phone: 440-960-3954
  • Fax: 440-960-3956
Mailing address:
  • Phone: 440-998-3801
  • Fax: 440-960-0264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35035173
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: