Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME121319 | FL |
N | 207XS0106X | Orthopaedic Hand Surgeon | ME121319 | FL |
N | 207XS0117X | Orthopaedic Spine Surgeon | ME121319 | FL |
NPI | 1093950214 |
---|---|
Provider Name | Lee Garrit Phillips |
First Address | St Petersburg, FL 33701-4629 |
Second Address | St Petersburg, FL 33701-4629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2008 |
Last Update Date | 12/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
013321400 | (05) | FL |