Provider Demographics
NPI:1255431128
Name:LEE, JOANNE MAY (MD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:MAY
Last Name:LEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11616 WATERSTONE LOOP DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1629 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3025
Practice Address - Country:US
Practice Address - Phone:863-687-1259
Practice Address - Fax:863-284-1786
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96759208600000X
IL036-143939208600000X, 2086S0102X
AZ53381208600000X
IL0361439392086S0127X
MA2690642086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9183233OtherAETNA
FL1255431128OtherUHC
FL322558OtherAVMED
FL6865839OtherCIGNA
FL1497748743OtherGROUP NPI NUMBER / LRHSI
FLDA5786OtherRAILROAD MEDICARE GROUP #
FL15914301OtherCITRUS HEALTHCARE
FL277446100Medicaid
FL472664OtherWELLCARE /STAYWELL/ HEALTHEASE
FL58203OtherBCBS OF FLORIDA
FLAA162YMedicare PIN