Provider Demographics
NPI:1447243878
Name:YOUNG, ANDREW L (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 SOUTH ASHLEY DRIVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5318
Mailing Address - Country:US
Mailing Address - Phone:813-899-6220
Mailing Address - Fax:813-985-8006
Practice Address - Street 1:100 SOUTH ASHLEY DRIVE
Practice Address - Street 2:SUITE 1500
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5318
Practice Address - Country:US
Practice Address - Phone:813-899-6220
Practice Address - Fax:813-985-8006
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2015-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA220245174400000X
CAA950872085R0202X
FLME1118512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL'011918500Medicaid
MA2236171OtherFIRST HEALTH
NH30204317OtherNH MEDICAID
MA5540164OtherFIRST HEALTH CCN
MAP00196700OtherRAIL ROAD MEDICARE
MA68312OtherHEALTHY START
MA68312OtherCHILDREN'S MEDICAL
NH0108933Y0MA01OtherNH BLUE SHIELD
MA7800325OtherCIGNA
MA971089OtherNETWORK HEALTH PLAN
MA2045150Medicaid
MA469315OtherTUFTS HEALTH PLAN
MA90532OtherFALLON
MAAA17331OtherHARVARD PILGRIM HEALTH CA
MAJ27411OtherBLUE CROSS/BLUE SHIELD
MA3551415OtherAETNA/US HEALTHCARE
MA68312OtherHEALTHY START
FL'011918500Medicaid
MA5540164OtherFIRST HEALTH CCN