Provider Demographics
NPI:1134227713
Name:YOUNG, RAMONA LASHELLE SMITH (DO)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:LASHELLE SMITH
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 1:13000 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4745
Mailing Address - Country:US
Mailing Address - Phone:813-631-2613
Mailing Address - Fax:713-903-7977
Practice Address - Street 1:6500 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1629
Practice Address - Country:US
Practice Address - Phone:727-384-7727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPRN0000019972363LF0000X
FLOS171752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00118024OtherPROVIDER NUMBER
MN131257C714OtherPROVIDER NUMBER
MN2033409OtherPROVIDER NUMBER
MN232L2YOOtherPROVIDER NUMBER
MNHP41013OtherPROVIDER NUMBER
MN430699600OtherPROVIDER NUMBER
MN116817OtherPROVIDER NUMBER
MN962581040660OtherPROVIDER NUMBER
MNQ06423Medicare UPIN
MN500002574Medicare ID - Type UnspecifiedPROVIDER NUMBER