Individual
JACOB CHUNG LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6329 GALL BLVD, ZEPHYRHILLS, FL 33542-2515
(813) 788-7616
Mailing address
119 IVY LN, TENAFLY, NJ 07670-2410
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME132877
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
ME132877
FL
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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