Provider Demographics
NPI:1003813932
Name:LEE, JANET I (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:I
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10002 PRINCESS PALM AVE SUITE 332
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-8327
Mailing Address - Country:US
Mailing Address - Phone:813-571-7184
Mailing Address - Fax:813-654-4695
Practice Address - Street 1:7425 MONIKA MANOR DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5814
Practice Address - Country:US
Practice Address - Phone:813-879-8045
Practice Address - Fax:813-960-3299
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-03-03
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
FLME 87363207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2276357OtherCIGNA
FL7164660OtherAETNA
FL294950OtherAVMED
FL112427700Medicaid
FL48942OtherBLUE CROSS & BLUE SHIELD
FLP00211435OtherRAILROAD MEDICARE
FLI18096Medicare UPIN
FL2276357OtherCIGNA