Individual
JUAN C LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2700 UNIVERSITY SQUARE DR, TAMPA, FL 33612-5513
(813) 253-2721
(813) 253-2299
Mailing address
2700 UNIVERSITY SQUARE DR, TAMPA, FL 33612-5513
(813) 253-2721
(813) 253-2299
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
049913
GA
2085R0202X
Diagnostic Radiology Physician
Primary
ME101578
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003288400
—
FL
05
—
00909466B
—
GA
Enumeration date
07/28/2005
Last updated
08/30/2017
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