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General NPI Number Information
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NPI Number | 1265877484
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Entity Type | Individual
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Provider Name | JACOB ANDREW YOUNG M.D./M.B.A.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1143 NW 64TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32605-4218
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Country | US
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Telephone | 352-331-1201
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 N MILITARY TRL APT 357
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City | BOCA RATON
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State | FL
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Zip | 33496-3563
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Country | US
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Telephone | 561-504-8453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME139767
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License Number State | FL
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