Individual provider Active NPI

Miranda Mun-Lai Lee, MS, LAT, ATC

  • Athletic Trainer
  • Daytona Beach, FL
National Provider Identifier
1629702089
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL6346 Issued in FL
Practice address
1200 W International Speedway Blvd
Daytona Beach, FL 32114-2817
Phone
(386) 506-3989
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL6346 FL Primary

Addresses

Primary practice location

1200 W International Speedway Blvd
Daytona Beach, FL 32114-2817

Mailing address

2330 SW Williston Rd Apt 813
Gainesville, FL 32608-4028
Phone (860) 986-4532

Other practice location 1

230 Sands Parc Blvd Apt 307
Daytona Beach, FL 32117-0052
Phone (860) 986-4532

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
Master of Science

State licenses

LicenseStateTypeSpecialty
AL6346FLMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1629702089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SW WILLISTON RD APT 813",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084028",
            "telephone_number": "860-986-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W INTERNATIONAL SPEEDWAY BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142817",
            "telephone_number": "386-506-3989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Sands Parc Blvd Apt 307",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321170052",
            "country_code": "US",
            "telephone_number": "860-986-4532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIRANDA",
        "middle_name": "MUN-LAI",
        "name_prefix": "Miss",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL6346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.