Provider Demographics
NPI:1801864293
Name:YOUNAN, MAGDI (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDI
Middle Name:
Last Name:YOUNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15770 CEDAR GROVE LN
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6311
Mailing Address - Country:US
Mailing Address - Phone:317-626-9169
Mailing Address - Fax:561-838-4397
Practice Address - Street 1:15770 CEDAR GROVE LN
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6311
Practice Address - Country:US
Practice Address - Phone:317-626-9169
Practice Address - Fax:561-838-4397
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056805207L00000X
FLME94004207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0919562OtherCIGNA
FL37008OtherBSFL
G85349Medicare UPIN
FL37008Medicare ID - Type Unspecified