=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225988009
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | M R YOUNG TRUCKING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2026
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 614 HENRY AVE
-----------------------------------------------------
City | LEHIGH ACRES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33972-7925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 848-202-5017
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 614 HENRY AVE
-----------------------------------------------------
City | LEHIGH ACRES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33972-7925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 848-202-5017
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | ROBERT YOUNG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 848-202-5017
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347C00000X
-----------------------------------------------------
Taxonomy Name | Private Vehicle
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------