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Organization
YOUNETIC LLC
Active
Organization
YOUNETIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE KELLY SMITH (OPERATOR)
(863) 268-7990
Entity
Organization
Contact information
Practice address
122 E MAIN ST STE 186, LAKELAND, FL 33801-4655
(863) 268-7990
(863) 204-0648
Mailing address
122 E MAIN ST STE 186, LAKELAND, FL 33801-4655
(863) 268-7990
(863) 204-0648
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/25/2021
Last updated
05/19/2023
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