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Individual

MR. CHA LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7040 LAND O LAKES BLVD UNIT 103, LAND O LAKES, FL 34638-3201
(813) 803-7907
(813) 528-8960
Mailing address
7040 LAND O LAKES BLVD UNIT 103, LAND O LAKES, FL 34638-3201
(813) 803-7907
(813) 528-8960

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
42508020
WI
207Q00000X
Family Medicine Physician
Primary
ME163264
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001546
MEDICARE GROUP NUMBER
WI
05
34066500
WI
Enumeration date
08/29/2006
Last updated
12/11/2023
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