Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT0008977 | FL |
N | 2251C2600X | Cardiopulmonary | PT0008977 | FL |
N | 2251E1200X | Ergonomics | PT0008977 | FL |
N | 225XE1200X | Ergonomics | PT0008977 | FL |
N | 2251E1300X | Electrophysiology, Clinical | PT0008977 | FL |
N | 2251G0304X | Physical Therapist - Geriatrics | PT0008977 | FL |
N | 2251H1200X | Hand | PT0008977 | FL |
N | 2251H1300X | Human Factors | PT0008977 | FL |
N | 225XH1300X | Human Factors | PT0008977 | FL |
N | 2251N0400X | Physical Therapist - Neurology | PT0008977 | FL |
N | 2251P0200X | Physical Therapist - Pediatrics | PT0008977 | FL |
N | 2251S0007X | Physical Therapist - Sports | PT0008977 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT0008977 | FL |
NPI | 1730660531 |
---|---|
Provider Name | Dr. Kenneth Lee |
First Address | Miramar, FL 33027-3838 |
Second Address | Miramar, FL 33027-3838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2018 |
Last Update Date | 24/04/2019 |