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General NPI Number Information
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NPI Number | 1932453750
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Entity Type | Organization
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Legal Business Name | YOUNG EYE ASSOICATES, O.D., P.A.
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 10676 NW 19TH ST
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City | DORAL
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State | FL
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Zip | 33172-2542
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Country | US
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Telephone | 305-403-3937
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Fax | 305-403-6967
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Provider Business Mailing Address
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Address Line | 10676 NW 19TH ST
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City | DORAL
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State | FL
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Zip | 33172-2542
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUY M YOUNG
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Credential | O.D.
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Telephone | 305-403-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3765
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License Number State | FL
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