Provider Demographics
NPI:1841236890
Name:LEE, STEVEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
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 1:9050 PINES BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6455
Mailing Address - Country:US
Mailing Address - Phone:954-437-4800
Mailing Address - Fax:954-437-6628
Practice Address - Street 1:1901 SW 172ND AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5592
Practice Address - Country:US
Practice Address - Phone:954-538-4864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070413L2085R0202X
FLME992102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00178715900006Medicaid
FL278478500Medicaid
PA00178715900006Medicaid
FL278478500Medicaid