Individual
CATHY A YOUNGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 HEALTH PARK BLVD., ST. AUGUSTINE, FL 32086-5776
(904) 826-3469
(904) 826-0374
Mailing address
130 HEALTH PARK BLVD., ST. AUGUSTINE, FL 32086-5776
(904) 826-3469
(904) 826-0374
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1554
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0290629500
—
FL
01
—
P00191661
PALMETTO GBA RAILROAD MED
FL
Enumeration date
04/27/2006
Last updated
12/10/2007
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