Provider Demographics
NPI:1174829014
Name:YASUDA, MARCELO TOSHIO (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCELO
Middle Name:TOSHIO
Last Name:YASUDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 LOCK RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-3641
Mailing Address - Country:US
Mailing Address - Phone:954-709-9778
Mailing Address - Fax:
Practice Address - Street 1:2323 NE 26TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-784-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor