Organization
EDGEWATER INTERNAL MEDICINE ASSOC. INC.
Active
Parent organization
EDGEWATER INTERNAL MEDICINE ASSOCIATES
Other names
Leslie M Lee MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDGEWATER INTERNAL MEDICINE ASSOCIATES
Authorized official
DR. LESLIE MANUEL LEE MD (PRESIDENT OWNER)
(386) 428-4640
Entity
Organization
Contact information
Practice address
2568 S. RIDGEWOOD AVE, SUITE 5, EDGEWATER, FL 32141-7535
(386) 428-4640
(386) 426-1409
Mailing address
2568 SOUTH RIDGEWOOD AVE, SUITE 5, EDGEWATER, FL 32111-7535
(386) 428-4640
(386) 426-1409
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0063341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23541
BCBS
—
Enumeration date
01/30/2006
Last updated
08/04/2014
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