MEDICARE: ROSA M LEE PT

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	225700000X	Massage Therapist	MA30720	FL
2	225100000X	Physical Therapist	PT17999	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1104938307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA M LEE PT

Provider Business Mailing Address
First Line	:	9960 NW 116TH WAY STE 13
Second Line	:
City	:	MEDLEY
State	:	FL
Zip	:	33178-1175
Country	:	US
Telephone Number	:	786-924-1311
Fax Number	:

Provider Business Practice Location Address
First Line	:	9085 SW 87TH AVE STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2309
Country	:	US
Telephone Number	:	305-412-3336
Fax Number	:	855-882-7612

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	04/24/2025

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Directions to “ ROSA M LEE PT” Practice Location

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