Individual
KYLE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5301 S CONGRESS AVE, SUITE 300, ATLANTIS, FL 33462-1149
(561) 548-4900
(561) 548-4902
Mailing address
5301 S CONGRESS AVE, SUITE 300, ATLANTIS, FL 33462-1149
(561) 548-4900
(561) 548-4902
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1612-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41987300
—
WI
01
—
GB931Z
MEDICARE ID
FL
Enumeration date
01/11/2006
Last updated
02/08/2022
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