Provider Demographics
NPI:1568006757
Name:LEE, ALLEN RAY JR (LDO)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:RAY
Last Name:LEE
Suffix:JR
Gender:M
Credentials:LDO
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Mailing Address - Street 1:935 OVIEDO BLVD STE 1007
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-3518
Mailing Address - Country:US
Mailing Address - Phone:407-720-9968
Mailing Address - Fax:407-845-9368
Practice Address - Street 1:935 OVIEDO BLVD STE 1007
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-3518
Practice Address - Country:US
Practice Address - Phone:407-720-9968
Practice Address - Fax:407-845-9368
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDO5906156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician