Healthcare Provider Details

I. General information

NPI: 1437177029
Provider Name (Legal Business Name): DONG ALEXANDER LEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEXANDER DONG LEE MD

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 NE 33RD ST
LIGHTHOUSE POINT FL
33064-8143
US

IV. Provider business mailing address

2420 NE 33RD ST
LIGHTHOUSE POINT FL
33064-8143
US

V. Phone/Fax

Practice location:
  • Phone: 954-786-7122
  • Fax: 954-786-7158
Mailing address:
  • Phone: 954-786-7122
  • Fax: 954-786-7158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0078771
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier62741
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerBCBS
# 2
IdentifierP00414211
Identifier TypeOTHER
Identifier State
Identifier IssuerRR MCR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: