Provider Demographics
NPI:1982920864
Name:YOUNG, DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11444 S APOPKA VINELAND RD UNIT 106A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-7009
Mailing Address - Country:US
Mailing Address - Phone:407-461-0038
Mailing Address - Fax:
Practice Address - Street 1:11444 S APOPKA VINELAND RD UNIT 106A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-7009
Practice Address - Country:US
Practice Address - Phone:407-238-2306
Practice Address - Fax:407-238-2309
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003619600Medicaid
FL003619600Medicaid