Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME97769 | FL |
NPI | 1043341795 |
---|---|
Provider Name | Annabelle K Lee |
First Address | Salt Lake City, UT 84145-0443 |
Second Address | Jacksonville, FL 32258-2451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 19/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2777541-00 | (05) | FL |