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Individual

MRS. JOAN ODETTA LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1765 NW 189TH TER, MIAMI GARDENS, FL 33056-3334
(305) 303-1219
Mailing address
1765 NW 189TH TER, MIAMI GARDENS, FL 33056-3334
(305) 303-1219
(305) 503-7096

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
686664696
FL
Enumeration date
01/27/2022
Last updated
01/27/2022
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