Healthcare Provider Details

I. General information

NPI: 1184570384
Provider Name (Legal Business Name): CHRISTIAN DIDYOUNG PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 ASBURY WAY
BOYNTON BEACH FL
33426-5527
US

IV. Provider business mailing address

1516 ASBURY WAY
BOYNTON BEACH FL
33426-5527
US

V. Phone/Fax

Practice location:
  • Phone: 561-213-1763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11045749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: