Provider Demographics
NPI:1265877484
Name:YOUNG, JACOB ANDREW (MD/MBA)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:ANDREW
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD/MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5500 N MILITARY TRL APT 357
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-3563
Mailing Address - Country:US
Mailing Address - Phone:561-504-8453
Mailing Address - Fax:
Practice Address - Street 1:7280 W PALMETTO PARK RD STE 305
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3427
Practice Address - Country:US
Practice Address - Phone:561-955-6025
Practice Address - Fax:561-955-6069
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME139767208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology