Individual
LISA S. YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
433 DEL ALTO AVE NE, PALM BAY, FL 32907-2086
(321) 327-4233
Mailing address
433 DEL-ALTO AVE., PALM BAY, FL 32907
(321) 327-4233
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230381700
FLOIRDA MEDICAID PROVDER NUMBER
FL
Enumeration date
07/03/2008
Last updated
07/03/2008
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