Provider Demographics
NPI:1164469490
Name:YEE, STEPHANIE ELAINE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:YEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N ORLANDO AVE
Mailing Address - Street 2:SUITE 139
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7313
Mailing Address - Country:US
Mailing Address - Phone:407-644-2211
Mailing Address - Fax:407-644-1686
Practice Address - Street 1:501 N ORLANDO AVE
Practice Address - Street 2:SUITE 139
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7313
Practice Address - Country:US
Practice Address - Phone:407-644-2211
Practice Address - Fax:407-644-1686
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3409152W00000X
VA0618000810152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3418Medicare ID - Type Unspecified
FLU75222Medicare UPIN