Organization
YOUNG PAIN AND REHAB CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUNG SOO SUH P.T. (P.T. DIRECTOR)
(813) 884-3773
Entity
Organization
Contact information
Practice address
7520 W WATERS AVE, SUITE 12, TAMPA, FL 33615-1599
(813) 884-3773
(813) 884-3855
Mailing address
7520 W WATERS AVE, SUITE 12, TAMPA, FL 33615-1599
(813) 884-3773
(813) 884-3855
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MM 13883
FL
302R00000X
Health Maintenance Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y6059
BLUECROSS-BLUESHIELD
FL
Enumeration date
02/02/2007
Last updated
09/11/2025
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