Provider Demographics
NPI:1558437707
Name:YOON, DAVID K (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1180 W GRANADA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8165
Mailing Address - Country:US
Mailing Address - Phone:386-677-2606
Mailing Address - Fax:386-672-5341
Practice Address - Street 1:1180 W GRANADA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8165
Practice Address - Country:US
Practice Address - Phone:386-677-2606
Practice Address - Fax:386-672-5341
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0049664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D20749Medicare UPIN
FLK3404Medicare PIN