Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | ME59411 | FL |
NPI | 1144252297 |
---|---|
Provider Name | Dr. Ann Marie Lee |
First Address | Sunrise, FL 33323-2865 |
Second Address | St Petersburg, FL 33701-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME5941 | (02) |