Provider Demographics
NPI:1790759397
Name:YUZON, FLORENCIO E (MD)
Entity Type:Individual
Prefix:
First Name:FLORENCIO
Middle Name:E
Last Name:YUZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636643
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6643
Mailing Address - Country:US
Mailing Address - Phone:440-998-3801
Mailing Address - Fax:440-960-0264
Practice Address - Street 1:3600 KOLBE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1654
Practice Address - Country:US
Practice Address - Phone:440-960-3954
Practice Address - Fax:440-960-3956
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035173207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
112531441OtherRAILROAD MEDICARE
OH0231458Medicaid
OH3025372Medicaid
OH0231458Medicaid
OH9389631Medicare PIN
OHYU0394811Medicare PIN
OHH234271Medicare PIN
OH3025372Medicaid