Provider Demographics
NPI:1598285587
Name:YOUNG, BRITTANIE (DO)
Entity Type:Individual
Prefix:
First Name:BRITTANIE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 STATE ROAD 100
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-3701
Mailing Address - Country:US
Mailing Address - Phone:386-659-2104
Mailing Address - Fax:386-659-2196
Practice Address - Street 1:1326 STATE ROAD 100
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:FL
Practice Address - Zip Code:32666-3701
Practice Address - Country:US
Practice Address - Phone:386-659-2104
Practice Address - Fax:386-659-2196
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL41049207Q00000X
FLOS18218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty