MEDICARE: GEORGE YOUAKIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center	6027321HCCE	FL

General Provider Information

NPI Number	:	1295503662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE YOUAKIM

Provider Business Mailing Address
First Line	:	4522 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4522 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5204
Country	:	US
Telephone Number	:	954-335-7633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2023
Last Update Date	:	12/15/2023

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Directions to “ GEORGE YOUAKIM ” Practice Location

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