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General NPI Number Information
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NPI Number | 1760311740
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Entity Type | Individual
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Provider Name | STEPHANIE T LEE
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Gender | Female
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Dates
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Enumeration Date | 05/16/2026
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Last Update Date | 05/16/2026
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Provider Practice Location Address
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Address Line | 14575 NE 21ST ST LOT E01
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City | SILVER SPGS
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State | FL
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Zip | 34488-8410
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Country | US
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Telephone | 561-247-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 14575 NE 21ST ST LOT E01
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City | SILVER SPGS
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State | FL
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Zip | 34488-8410
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Country | US
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Telephone | 561-247-2555
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | CL1290056
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License Number State | FL
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