Provider Demographics
NPI:1780939637
Name:LEE, CLAIRE M (OD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:M
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:50 BISCAYNE BLVD APT 2705
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2937
Mailing Address - Country:US
Mailing Address - Phone:650-922-5840
Mailing Address - Fax:
Practice Address - Street 1:11099 SW 10TH STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-2905
Practice Address - Country:US
Practice Address - Phone:305-348-8439
Practice Address - Fax:305-348-8330
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV736152W00000X
FLOPC 5120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist