Healthcare Provider Details

I. General information

NPI: 1720822836
Provider Name (Legal Business Name): SOMAYE YOUNESIAN MD,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E SAMPLE RD FL 33064
DEERFIELD BEACH FL
33064-3502
US

IV. Provider business mailing address

1242 S PINE ISLAND RD APT 210
PLANTATION FL
33324-4565
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-8300
  • Fax:
Mailing address:
  • Phone: 954-632-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: