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NPI Code Detail

MEDICARE: ROBERT LEE JR. LCSW

MEDICARE: ROBERT LEE JR. LCSW
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
11041C0700XClinical Social WorkerSW19339FL

General Provider Information

NPI Number : 1629484498
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT LEE JR. LCSW
Provider Business Mailing Address
First Line : 3464 AVALON PARK EAST BLVD STE 13251
Second Line :
City : ORLANDO
State : FL
Zip : 32828-7363
Country : US
Telephone Number : 321-966-9363
Fax Number :
Provider Business Practice Location Address
First Line : 3464 AVALON PARK EAST BLVD STE 13251
Second Line :
City : ORLANDO
State : FL
Zip : 32828-7363
Country : US
Telephone Number : 321-966-9363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2014
Last Update Date : 11/30/2022

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Directions to “ ROBERT LEE JR. LCSW” Practice Location

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