Individual
DR. MARVIN JASON YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1071 S SUN DR, SUITE 1003, LAKE MARY, FL 32746-2405
(407) 302-2620
(407) 302-2690
Mailing address
1071 S SUN DR, SUITE 1003, LAKE MARY, FL 32746-2405
(407) 302-2620
(407) 302-2690
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME80601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000105000
—
FL
05
—
GROUP # 000354800
—
FL
01
—
ME80601
STATE LICENSE #
FL
01
—
PTAN# DO3210
RR MEDICARE
FL
Enumeration date
09/28/2006
Last updated
03/07/2023
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