Provider Demographics
NPI:1669834495
Name:LEE, MING HUA (MD)
Entity Type:Individual
Prefix:DR
First Name:MING
Middle Name:HUA
Last Name:LEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-3901
Mailing Address - Country:US
Mailing Address - Phone:352-377-8619
Mailing Address - Fax:352-371-9674
Practice Address - Street 1:4525 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-3901
Practice Address - Country:US
Practice Address - Phone:352-377-8619
Practice Address - Fax:352-371-9674
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-43050207N00000X
IL036.151547207NS0135X
FLME155353207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty