Provider Demographics
NPI:1013783455
Name:OKADA, YUSUKE
Entity Type:Individual
Prefix:
First Name:YUSUKE
Middle Name:
Last Name:OKADA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 NETWORK PL APT 201A
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-2122
Mailing Address - Country:US
Mailing Address - Phone:620-636-1348
Mailing Address - Fax:
Practice Address - Street 1:2922 NETWORK PL APT 201A
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-2122
Practice Address - Country:US
Practice Address - Phone:620-636-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program