Active NPI
Gabriel Lee, M.D.
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1356313415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101058001
- Practice address
- 2080 Child St
Naval Hospital Jacksonville, FL, Dept of Pediatrics
Jacksonville, FL 32214-5005 - Phone
- (904) 542-7992
- NPI assigned
- Feb 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101058001 | VA | Primary |
Addresses
Primary practice location
2080 Child St
Naval Hospital Jacksonville, FL, Dept of Pediatrics
Jacksonville, FL 32214-5005
Mailing address
1916 Bluebonnet Way
Fleming Island, FL 32003-7461
Phone (904) 264-4371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101058001 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259020800000",
"number": "1356313415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1916 BLUEBONNET WAY",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320037461",
"telephone_number": "904-264-4371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 CHILD ST",
"address_2": "NAVAL HOSPITAL JACKSONVILLE, FL, DEPT OF PEDIATRICS",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322145005",
"telephone_number": "904-542-7992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "GABRIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2009-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101058001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.