Provider Demographics
NPI:1568569572
Name:PERRI ELIZABETH YOUNG, M.D., P.A.
Entity Type:Organization
Organization Name:PERRI ELIZABETH YOUNG, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-663-0609
Mailing Address - Street 1:6200 SUNSET DR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4828
Mailing Address - Country:US
Mailing Address - Phone:305-663-0609
Mailing Address - Fax:305-667-7459
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 501
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4828
Practice Address - Country:US
Practice Address - Phone:305-663-0609
Practice Address - Fax:305-667-7459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28025Medicare UPIN
FLK6827Medicare PIN