Provider Demographics
NPI:1013198357
Name:KAREN LEE DPM PA
Entity Type:Organization
Organization Name:KAREN LEE DPM PA
Other - Org Name:PODIATRIC ASSOCIATES FOOT & ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF PODIATRY MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-437-0200
Mailing Address - Street 1:10041 PINES BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6170
Mailing Address - Country:US
Mailing Address - Phone:954-437-0200
Mailing Address - Fax:954-436-2159
Practice Address - Street 1:10041 PINES BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6170
Practice Address - Country:US
Practice Address - Phone:954-437-0200
Practice Address - Fax:954-436-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2702174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65563XOtherMEDICARE PROVIDER NUMBER
FL390451200Medicaid
FLU71937Medicare UPIN
FL390451200Medicaid