Provider Demographics
NPI:1689644619
Name:FLORES, EUSEBIO III (PA-C, MPAS, M ED)
Entity Type:Individual
Prefix:MR
First Name:EUSEBIO
Middle Name:
Last Name:FLORES
Suffix:III
Gender:M
Credentials:PA-C, MPAS, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BHC ATSUGI
Mailing Address - Street 2:PSC 477 BOX 2
Mailing Address - City:ATSUGI
Mailing Address - State:JAPAN
Mailing Address - Zip Code:FPO AP 96306
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BHC ATSUGI
Practice Address - Street 2:PSC 477 BOX 2
Practice Address - City:ATSUGI
Practice Address - State:JAPAN
Practice Address - Zip Code:FPO AP 96306
Practice Address - Country:JP
Practice Address - Phone:0118146-763-4693
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical