Provider Demographics
NPI:1922259928
Name:LEE, TSE C (MD)
Entity Type:Individual
Prefix:
First Name:TSE
Middle Name:C
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 1:8880 ROYAL PALM BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5727
Mailing Address - Country:US
Mailing Address - Phone:549-975-8233
Mailing Address - Fax:954-974-2335
Practice Address - Street 1:8880 ROYAL PALM BLVD STE 103
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5727
Practice Address - Country:US
Practice Address - Phone:954-975-8233
Practice Address - Fax:954-974-2335
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL102935208100000X
FLME102935208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AW648ZMedicare UPIN
FL45246Medicare PIN