Individual
BRYCE KELLY YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 NW 12TH AVE, MIAMI, FL 33136-1003
(305) 243-5512
(305) 243-4613
Mailing address
1611 NW 12TH AVE # 279, MIAMI, FL 33136-1005
(305) 585-7878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R9277
IA
2085R0202X
Diagnostic Radiology Physician
Primary
ME129889
FL
Other
Enumeration date
06/15/2011
Last updated
10/05/2017
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