Provider Demographics
NPI:1992084818
Name:LEE, YUN-CHIAO (DOM, AP)
Entity type:Individual
Prefix:
First Name:YUN-CHIAO
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 S VOLUSIA AVE STE C4
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7626
Mailing Address - Country:US
Mailing Address - Phone:407-690-7696
Mailing Address - Fax:407-610-0287
Practice Address - Street 1:237 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8433
Practice Address - Country:US
Practice Address - Phone:407-690-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14027171100000X
FLAP2976171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist