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General NPI Number Information
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NPI Number | 1225307424
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Entity Type | Organization
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Legal Business Name | ROBERT R. YOUNG, M.D. P.A.
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 163 E INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4648
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Country | US
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Telephone | 386-253-4207
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Fax | 386-258-8033
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Provider Business Mailing Address
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Address Line | 163 E INTERNATIONAL SPEEDWAY BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4648
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Country | US
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Telephone | 386-253-4207
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Fax | 386-258-8033
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT YOUNG
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Credential | M.D.
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Telephone | 386-253-4207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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