Provider Demographics
NPI:1235984717
Name:YOUNG, ALYCIA F
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:F
Last Name:YOUNG
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 1:255 S ORANGE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3411
Mailing Address - Country:US
Mailing Address - Phone:407-900-7832
Mailing Address - Fax:
Practice Address - Street 1:6415 POWERS POINTE CIR FL 32810
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-1382
Practice Address - Country:US
Practice Address - Phone:407-900-7832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No174400000XOther Service ProvidersSpecialist
No1744P3200XOther Service ProvidersSpecialistProsthetics Case Management