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Individual

DR. JONG Y LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1611 NW 12TH AVE, BOX 016960 (M851), MIAMI, FL 33136-1005
(305) 243-6358
(305) 243-8470
Mailing address
1611 NW 12TH AVE, BOX 016960 (M851), MIAMI, FL 33136-1005
(305) 243-6358
(305) 243-8470

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD436059
PA
207L00000X
Anesthesiology Physician
Primary
ME89153
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
MD436059
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2698528-00
FL
05
2698528-00
PA
01
43304
MEDICARE ID/UNSPECIFIED
PA
Enumeration date
07/07/2006
Last updated
08/20/2009
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