Healthcare Provider Details

I. General information

NPI: 1124136742
Provider Name (Legal Business Name): JANICE NICOLE YOUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PIPER BLVD STE 21
NAPLES FL
34110-1385
US

IV. Provider business mailing address

1201 PIPER BLVD STE 21
NAPLES FL
34110-1385
US

V. Phone/Fax

Practice location:
  • Phone: 239-591-3311
  • Fax: 239-591-3327
Mailing address:
  • Phone: 239-591-3311
  • Fax: 239-591-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberME62510
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME62510
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: