Individual
SEONG GON BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4106 W LAKE MARY BLVD STE 330, LAKE MARY, FL 32746-3383
(407) 833-9195
Mailing address
4106 W LAKE MARY BLVD STE 330, LAKE MARY, FL 32746-3383
(407) 833-9195
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A123341
CA
208600000X
Surgery Physician
Primary
ME128524
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/15/2007
Last updated
02/06/2023
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