Provider Demographics
NPI:1154783728
Name:LEE, LAWRENCE (MD PHD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 235 BOX 38
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-303-5947
Mailing Address - Fax:407-303-7323
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 235 BOX 38
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-303-5947
Practice Address - Fax:407-303-7323
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program