Provider Demographics
NPI:1134364060
Name:LEE, WENCHI (A P)
Entity type:Individual
Prefix:DR
First Name:WENCHI
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:A P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 CITRUS TOWER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6801
Mailing Address - Country:US
Mailing Address - Phone:352-241-4103
Mailing Address - Fax:
Practice Address - Street 1:3741 S HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7705
Practice Address - Country:US
Practice Address - Phone:352-241-4103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
FLAP2519171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP2519OtherACUPUNCTURE LICENSE