Provider Demographics
NPI:1538879077
Name:A YOUNGER YOU, PLLC
Entity type:Organization
Organization Name:A YOUNGER YOU, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:386-202-1401
Mailing Address - Street 1:1431 ORANGE CAMP RD STE 115
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-7770
Mailing Address - Country:US
Mailing Address - Phone:386-202-1401
Mailing Address - Fax:386-202-1402
Practice Address - Street 1:1431 ORANGE CAMP RD STE 115
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-7770
Practice Address - Country:US
Practice Address - Phone:386-202-1401
Practice Address - Fax:386-202-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center