Provider Demographics
NPI:1053066118
Name:YOUNGBLOOD, DINESHIA
Entity Type:Individual
Prefix:
First Name:DINESHIA
Middle Name:
Last Name:YOUNGBLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 ARGYLE BUSINESS LOOP APT 1120
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-6710
Mailing Address - Country:US
Mailing Address - Phone:904-520-1599
Mailing Address - Fax:
Practice Address - Street 1:8500 ARGYLE BUSINESS LOOP APT 1120
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-6710
Practice Address - Country:US
Practice Address - Phone:904-520-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health