Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME75595 | FL |
NPI | 1083683106 |
---|---|
Provider Name | Edwin N Lee |
First Address | Orlando, FL 32819-5123 |
Second Address | Orlando, FL 32819-5123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 16/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
254502100 | (05) | FL |
460002163 | MEDICARE ID/RRM PIN (01) | FL |
G58693 | (02) | FL |