Healthcare Provider Details

I. General information

NPI: 1952460263
Provider Name (Legal Business Name): STEVE YOUNG RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 PARK PLACE BLVD SUITE 150
CLEARWATER FL
33759-4930
US

IV. Provider business mailing address

380 PARK PLACE BLVD SUITE 150
CLEARWATER FL
33759-4930
US

V. Phone/Fax

Practice location:
  • Phone: 727-726-6669
  • Fax: 727-726-0688
Mailing address:
  • Phone: 727-726-6669
  • Fax: 727-726-0688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN2786482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: