Provider Demographics
NPI:1437177029
Name:LEE, DONG ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:DONG
Middle Name:ALEXANDER
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEXANDER
Other - Middle Name:DONG
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2420 NE 33RD ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-8143
Mailing Address - Country:US
Mailing Address - Phone:954-786-7122
Mailing Address - Fax:954-786-7158
Practice Address - Street 1:2420 NE 33RD ST
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-8143
Practice Address - Country:US
Practice Address - Phone:954-786-7122
Practice Address - Fax:954-786-7158
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0078771207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62741OtherBCBS
P00414211OtherRR MCR
FL62741AMedicare PIN
FL62741OtherBCBS