Provider Demographics
NPI:1760089536
Name:LALEE LLC
Entity Type:Organization
Organization Name:LALEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAVERNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-223-2793
Mailing Address - Street 1:28 MALDEN CIR
Mailing Address - Street 2:
Mailing Address - City:WHEATLEY HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11798-1507
Mailing Address - Country:US
Mailing Address - Phone:631-644-4871
Mailing Address - Fax:
Practice Address - Street 1:28 MALDEN CIR
Practice Address - Street 2:
Practice Address - City:WHEATLEY HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11798-1507
Practice Address - Country:US
Practice Address - Phone:786-223-2793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty