Individual
ROBERT M LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
43309 US HIGHWAY 19 N, TARPON SPRINGS, FL 34689-6221
(727) 943-3111
Mailing address
1008 N MAIN ST, BLOOMINGTON, IL 61701-1784
(309) 829-5311
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036088234
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L30735
MEDICARE PTAN
IL
Enumeration date
06/08/2006
Last updated
04/11/2023
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