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General NPI Number Information
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NPI Number | 1841259348
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Entity Type | Individual
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Provider Name | KEN W LEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 8725 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-2239
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Country | US
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Telephone | 321-434-9568
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Fax | 321-434-9231
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 321-434-9568
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | ME133936
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License Number State | FL
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