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General NPI Number Information
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NPI Number | 1265079891
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Entity Type | Individual
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Provider Name | SIJIN LEE DPT
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Gender | Male
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Dates
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Enumeration Date | 12/02/2019
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 4016 CHASE AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3421
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Country | US
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Telephone | 305-538-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 SE 10TH AVE APT 8118
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-3191
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Country | US
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Telephone | 954-400-9096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 35281
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License Number State | FL
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