Individual
GARY W YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1723 LUCERNE TER, ORLANDO, FL 32806-2916
(407) 843-1180
(407) 841-6160
Mailing address
1723 LUCERNE TER, ORLANDO, FL 32806-2916
(407) 843-1180
(407) 841-6160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME30467
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03343
BCBS
FL
05
—
058409600
—
FL
01
—
110090542
RAILROAD MEDICARE
—
Enumeration date
05/31/2006
Last updated
12/08/2009
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