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General NPI Number Information
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NPI Number | 1720709686
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Entity Type | Individual
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Provider Name | CHRISTIAN ALFONSO LEE CAA
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Gender | Male
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1525 W CYPRESS CREEK RD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1831
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Country | US
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Telephone | 800-437-2672
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Fax |
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Provider Business Mailing Address
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Address Line | 5881 NW 198TH TER
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City | HIALEAH
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State | FL
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Zip | 33015-4904
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Country | US
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Telephone | 305-685-3274
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA747
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License Number State | FL
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