MEDICARE: LAUREN NEIGHBORS YOUTZ PA-C

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	363A00000X	Physician Assistant	9106427	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407292220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN NEIGHBORS YOUTZ PA-C

Provider Business Mailing Address
First Line	:	479 E. HWY 20
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439
Country	:	US
Telephone Number	:	850-880-6568
Fax Number	:

Provider Business Practice Location Address
First Line	:	479 HIGHWAY 20 E
Second Line	:
City	:	FREEPORT
State	:	FL
Zip	:	32439-3931
Country	:	US
Telephone Number	:	850-880-6568
Fax Number	:

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

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	04/12/2023

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