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General NPI Number Information
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NPI Number | 1255171583
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Entity Type | Individual
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Provider Name | HENRIQUE OCHOA SCUSSIATTO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 3927 OSVALDO CRUZ STREET HOUSE 2
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City | CASCAVEL
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State | PR
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Zip | 81811
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Country | BR
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Telephone | 459-882-5976
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Fax |
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Provider Business Mailing Address
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Address Line | 3927 OSVALDO CRUZ STREET HOUSE 2
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City | CASCAVEL
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State | PR
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Zip | 81811
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Country | BR
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 125084504
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License Number State | IL
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