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NPI Code Detail

MEDICARE: MRS. HAZEL A LEE LMT

MEDICARE:  MRS. HAZEL A LEE  LMT
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
1225700000XMassage TherapistMA92020FL

General Provider Information

NPI Number : 1386493005
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HAZEL A LEE LMT
Provider Business Mailing Address
First Line : 9014 SIBBALD RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-7617
Country : US
Telephone Number : 904-226-6580
Fax Number :
Provider Business Practice Location Address
First Line : 6680 BENNETT CREEK DR APT 437
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-0020
Country : US
Telephone Number : 904-761-5896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2024
Last Update Date : 05/15/2024

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Directions to “ MRS. HAZEL A LEE LMT” Practice Location

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