MEDICARE: DINESHIA YOUNGBLOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1053066118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINESHIA YOUNGBLOOD

Provider Business Mailing Address
First Line	:	8500 ARGYLE BUSINESS LOOP APT 1120
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6710
Country	:	US
Telephone Number	:	904-520-1599
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 ARGYLE BUSINESS LOOP APT 1120
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6710
Country	:	US
Telephone Number	:	904-520-1599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	02/17/2022

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Directions to “ DINESHIA YOUNGBLOOD ” Practice Location

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