MEDICARE: KARMELYN LEE

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	103K00000X	Behavior Analyst	1-19-35685	FL
2	101YM0800X	Mental Health Counselor		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	:	1871012427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARMELYN LEE

Provider Business Mailing Address
First Line	:	5103 RAVENSDALE WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-4827
Country	:	US
Telephone Number	:	813-434-3958
Fax Number	:	844-752-9036

Provider Business Practice Location Address
First Line	:	5103 RAVENSDALE WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-4827
Country	:	US
Telephone Number	:	201-673-7575
Fax Number	:

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

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	01/06/2026

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Directions to “ KARMELYN LEE ” Practice Location

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