Provider Demographics
NPI:1881663813
Name:LEE, RHONDA PETITE (BS, MBA)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:PETITE
Last Name:LEE
Suffix:
Gender:F
Credentials:BS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11472 TORI LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8830
Mailing Address - Country:US
Mailing Address - Phone:904-514-9788
Mailing Address - Fax:904-619-7878
Practice Address - Street 1:11472 TORI LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8830
Practice Address - Country:US
Practice Address - Phone:904-514-9788
Practice Address - Fax:904-619-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor