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Individual

ANDY LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 351-5384
(407) 445-0321
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 351-5384
(407) 445-0321

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109472
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017377100
FL
01
PA9109472
MEDICAL LICENSE
FL
Enumeration date
05/11/2016
Last updated
11/16/2016
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