MEDICARE: DR. HARRY W LEE MD

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
1	207P00000X	Emergency Medicine Physician	ME24378	FL

General Provider Information

NPI Number	:	1689677387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY W LEE MD

Provider Business Mailing Address
First Line	:	2856 NE 36TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5818
Country	:	US
Telephone Number	:	954-565-4810
Fax Number	:	919-425-1596

Provider Business Practice Location Address
First Line	:	1600 S ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2510
Country	:	US
Telephone Number	:	954-714-6322
Fax Number	:	919-425-1596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/15/2008

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