Provider Demographics
NPI:1205822087
Name:YOUNG, VICTOR C (DO)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2100
Mailing Address - Country:US
Mailing Address - Phone:407-282-2044
Mailing Address - Fax:407-658-1596
Practice Address - Street 1:11550 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2100
Practice Address - Country:US
Practice Address - Phone:407-282-2044
Practice Address - Fax:407-658-1596
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8339207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25010OtherBLUE CROSS BLUE SHIELD
FL261375100Medicaid
FL25010VMedicare PIN
FL25010OtherBLUE CROSS BLUE SHIELD
FL25010XMedicare PIN
FL261375100Medicaid