MEDICARE: EDWIN N LEE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME75595	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	460002163	OTHER	FL	MEDICARE ID/RRM PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083683106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN N LEE MD

Provider Business Mailing Address
First Line	:	7009 DR PHILLIPS BLVD
Second Line	:	SUITE 150
City	:	ORLANDO
State	:	FL
Zip	:	32819-5123
Country	:	US
Telephone Number	:	407-363-9665
Fax Number	:

Provider Business Practice Location Address
First Line	:	7009 DR PHILLIPS BLVD
Second Line	:	SUITE 150
City	:	ORLANDO
State	:	FL
Zip	:	32819-5123
Country	:	US
Telephone Number	:	407-363-9665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	10/16/2008

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Directions to “ EDWIN N LEE MD” Practice Location

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