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General NPI Number Information
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NPI Number | 1699960047
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Entity Type | Individual
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Provider Name | TIMOTHY LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2011
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Provider Practice Location Address
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Address Line | 5637 MARINE PKWY
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4316
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Country | US
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Telephone | 727-834-5715
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Fax | 727-834-5717
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Provider Business Mailing Address
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Address Line | 7544 DUNBRIDGE DR
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City | ODESSA
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State | FL
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Zip | 33556-2270
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Country | US
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Telephone | 813-785-6609
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME104592
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License Number State | FL
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