Provider Demographics
NPI:1114925989
Name:LEE, SCOTT FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:FRANK
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14153 YOSEMITE DR #202
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6575
Mailing Address - Country:US
Mailing Address - Phone:727-868-5405
Mailing Address - Fax:727-863-1787
Practice Address - Street 1:14153 YOSEMITE DR #202
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6575
Practice Address - Country:US
Practice Address - Phone:727-868-5405
Practice Address - Fax:727-863-1787
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119203207RC0000X, 207RC0001X
CAA68497207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010844000Medicaid
FL0010844000Medicaid
FLP00284498OtherRAILROAD MEDICARE
CA00A684970Medicare PIN
CA00A684971Medicare PIN
CAP00187400OtherRAILROAD MEDICARE
CA00A684970Medicaid
00A684974Medicare PIN
00A684973Medicare PIN