Individual
MRS. HISOON A LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA ARNP
Contact information
Practice address
21298 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6705
(941) 629-1181
Mailing address
2441 STAVER ST, PORT CHARLOTTE, FL 33980-5914
(239) 810-0313
(941) 875-9363
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
ARNP1654692
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN1654692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1654692
ARNP
—
05
—
304661300
—
FL
Enumeration date
06/27/2006
Last updated
12/13/2011
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