IndividualActive
Youngchan Lee
NPI 1053962936 · Physical Therapist · Jacksonville, FL
Provider details
- NPI number
- 1053962936
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- AC18612 (CA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Other Service Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3591 Kernan Blvd S Apt 816
Jacksonville, FL 32224-4674
Phone: (808) 258-5530
Street-level locationGet directions
Mailing address
3591 Kernan Blvd S Apt 816
Jacksonville, FL 32224-4674
Registry dates
- Enumerated
- 2019-09-23
- Last updated
- 2024-05-04
- Certified
- 2024-05-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.