MEDICARE: ARYANNA F. LEE M.D.

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	208000000X	Pediatrics Physician	ME82123	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	AS717Y	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13750	OTHER	FL	BCBS
2	5569738	OTHER	FL	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598752339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARYANNA F. LEE M.D.

Provider Business Mailing Address
First Line	:	3300 S FISKE BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4306
Country	:	US
Telephone Number	:	321-435-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	8057 SPYGLASS HILL RD STE 102
Second Line	:
City	:	VIERA
State	:	FL
Zip	:	32940-8565
Country	:	US
Telephone Number	:	321-435-9800
Fax Number	:	321-434-9803

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	05/17/2023

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Directions to “ ARYANNA F. LEE M.D.” Practice Location

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