Provider Demographics
NPI:1982913158
Name:TEMPLES, LEE J
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:J
Last Name:TEMPLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2886 MAGNOLIA BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-6394
Mailing Address - Country:US
Mailing Address - Phone:850-482-4850
Mailing Address - Fax:
Practice Address - Street 1:3008 JEFFERSON ST STE B
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2318
Practice Address - Country:US
Practice Address - Phone:850-526-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0033694183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist