Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME136018 | FL |
NPI | 1043370976 |
---|---|
Provider Name | Dr. Sena J Lee |
First Address | Fort Myers, FL 33908-5182 |
Second Address | Sarasota, FL 34239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 13/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043370976 | (05) | MO |