Provider Demographics
NPI:1104098128
Name:RICARDO A. YUZON, M.D., P.C.
Entity type:Organization
Organization Name:RICARDO A. YUZON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:YUZON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-656-5003
Mailing Address - Street 1:950 W AVON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2761
Mailing Address - Country:US
Mailing Address - Phone:248-656-5003
Mailing Address - Fax:248-656-5004
Practice Address - Street 1:950 W AVON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2761
Practice Address - Country:US
Practice Address - Phone:248-656-5003
Practice Address - Fax:248-656-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI032134261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P20040Medicare PIN