Individual
JASON M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8340 LAKEWOOD RANCH BLVD STE 300, LAKEWOOD RANCH, FL 34202-5046
(941) 792-1404
Mailing address
8000 SR 64 E, BRADENTON, FL 34212
(941) 792-1404
(941) 761-0712
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PAT9103767
FL
2085R0202X
Diagnostic Radiology Physician
PAT9103767
FL
363A00000X
Physician Assistant
Primary
PAT9103767
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAT9103767
MEDICAL LICENSE NUMBER
FL
Enumeration date
07/27/2006
Last updated
05/26/2022
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