Provider Demographics
NPI:1588622419
Name:ZEHNGEBOT, LEE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:M
Last Name:ZEHNGEBOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 S INTERLACHEN AVE UNIT 403
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4474
Mailing Address - Country:US
Mailing Address - Phone:407-256-3472
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 381
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4623
Practice Address - Country:US
Practice Address - Phone:407-898-5452
Practice Address - Fax:407-894-1183
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0046635207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376006500Medicaid
FLB82286Medicare UPIN
FL376006500Medicaid