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General NPI Number Information
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NPI Number | 1629309893
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Entity Type | Organization
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Legal Business Name | TSE CHUNG LEE, M.D., PL
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 1671 N CLYDE MORRIS BLVD STE 100
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5590
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Country | US
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Telephone | 386-274-2977
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Fax | 386-274-2966
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Provider Business Mailing Address
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Address Line | 1551 CROWNE VIEW DR # 818
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City | ORMOND BEACH
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State | FL
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Zip | 32174-0654
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Country | US
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Telephone | 419-787-5001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TSE CHUNG LEE
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Credential | M.D.
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Telephone | 419-787-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 102935
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License Number State | FL
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