=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184363350
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CINDY LEE D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2022
-----------------------------------------------------
Last Update Date | 09/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2015 CHILDRENS WAY
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41091-7829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-647-6700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 ROBERT DANIEL DR UNIT 1419
-----------------------------------------------------
City | DANIEL ISLAND
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29492-8941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-716-7626
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 34.017957
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | LL87642
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 06225
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------