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NPI Code Detail

MEDICARE: DR. GARY RICHARD YOUMANS M.D.

MEDICARE:  DR. GARY RICHARD YOUMANS  M.D.
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianME64488FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123455ZOTHERFLMEDICARE ID (UNSPECIFIED)

General Provider Information

NPI Number : 1851322119
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY RICHARD YOUMANS M.D.
Provider Business Mailing Address
First Line : 6006 49TH ST N STE 330
Second Line : IRL PATHOLOGY SERVICES GROUP WEST FLORIDA
City : ST PETERSBURG
State : FL
Zip : 33709-2149
Country : US
Telephone Number : 727-528-5859
Fax Number :
Provider Business Practice Location Address
First Line : 6006 49TH ST N
Second Line : 330
City : ST PETERSBURG
State : FL
Zip : 33709-2148
Country : US
Telephone Number : 727-528-5859
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 08/11/2016

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