MEDICARE: LEESANG SERVICES LLC

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	261QM2500X	Medical Specialty Clinic/Center
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1801604707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEESANG SERVICES LLC

Provider Business Mailing Address
First Line	:	1317 EDGEWATER DR # 2761
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	561-598-9609
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 EDGEWATER DR # 2761
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	561-598-9609
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LASANDRA LEE
Credential	:	APRN, FNP-C
Telephone Number	:	561-598-9609

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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Directions to “LEESANG SERVICES LLC ” Practice Location

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