Provider Demographics
NPI:1407421225
Name:LEE, JESSICA ANDERSON (PA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:ANDERSON
Last Name:LEE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:10000 W COLONIAL DR STE 284
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3432
Mailing Address - Country:US
Mailing Address - Phone:321-842-0400
Mailing Address - Fax:321-842-0242
Practice Address - Street 1:10000 W COLONIAL DR STE 284
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3432
Practice Address - Country:US
Practice Address - Phone:321-842-0400
Practice Address - Fax:321-842-0242
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-10-26
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant