Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 5101018898 | MI |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 71696 | GA |
Y | 2081P2900X | Pain Medicine | OS12124 | FL |
NPI | 1326363466 |
---|---|
Provider Name | Dr. Suyin J Lee |
First Address | Ponte Vedra Beach, FL 32004-0385 |
Second Address | St Johns, FL 32259-9370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 02/09/2021 |