Provider Demographics
NPI:1275420556
Name:AZIADOUVO, AIME VAUBANSON
Entity type:Individual
Prefix:
First Name:AIME
Middle Name:VAUBANSON
Last Name:AZIADOUVO
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 1:375 N 117TH CT APT 7
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2442
Mailing Address - Country:US
Mailing Address - Phone:240-264-0476
Mailing Address - Fax:
Practice Address - Street 1:375 N 117TH CT APT 7
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2442
Practice Address - Country:US
Practice Address - Phone:240-264-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist