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Individual

ERIC K YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1651 SE TIFFANY AVE, PORT ST LUCIE, FL 34952-7564
(772) 398-1800
(772) 398-1815
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-5665
(772) 223-5646

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME40258
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067073100
FL
Enumeration date
08/04/2006
Last updated
10/13/2020
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