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NPI Code Detail

MEDICARE: SIJIN LEE DPT

MEDICARE: SIJIN LEE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist35281FL

General Provider Information

NPI Number : 1265079891
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIJIN LEE DPT
Provider Business Mailing Address
First Line : 1919 SE 10TH AVE APT 8118
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33316-3191
Country : US
Telephone Number : 954-400-9096
Fax Number :
Provider Business Practice Location Address
First Line : 4016 CHASE AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-3421
Country : US
Telephone Number : 305-538-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 12/02/2019

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