NPIMap

Organization Active NPI

Wayne Lee MD Plastic Surgery PLLC

  • Plastic and Reconstructive Surgery Physician
  • Brandon, FL
National Provider Identifier
1710269097
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME93895 Issued in FL
Legal business name
WAYNE LEE MD PLASTIC SURGERY PLLC
Practice address
1020 E Brandon Blvd Ste 101
Brandon, FL 33511-5560
Phone
(813) 579-3369
NPI assigned
Sep 13, 2011
Last updated
Jan 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Dr. Wayne C Lee, MDNPI 1598833543
Title
President
Phone
(813) 579-3369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X ME93895 FL Primary

Addresses

Primary practice location

1020 E Brandon Blvd Ste 101
Brandon, FL 33511-5560

Mailing address

1971 W Lumsden Rd Ste 350
Brandon, FL 33511-8820
Phone (813) 579-3369

Other practice location 1

3000 Medical Park Dr Ste 140
Tampa, FL 33613-4679
Phone (813) 579-3369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110927000362 FL Part B Supplier - Clinic/Group Practice 6204007024 Receives reassigned benefits from 5 practitioners
Practice locations: Brandon, FL; Tampa, FL

National Provider Directory

National Provider Directory

Locations

1020 E Brandon Blvd
Ste 101
Brandon, FL 33511
Phone (813) 579-3369

1602 Oakfield Dr
Ste 109
Brandon, FL 33511
Phone (813) 579-3369

1971 W Lumsden Rd
Brandon, FL 33511
Phone (813) 549-7820

19105 N US Highway 41
Ste 300
Lutz, FL 33549
Phone (813) 751-0247

3000 Medical Park Dr
Ste 140
Tampa, FL 33613
Phone (813) 579-3369

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1710269097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 W LUMSDEN RD STE 350",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118820",
            "telephone_number": "813-579-3369",
            "fax_number": "866-202-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E BRANDON BLVD STE 101",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115560",
            "telephone_number": "813-579-3369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Medical Park Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134679",
            "country_code": "US",
            "telephone_number": "813-579-3369",
            "fax_number": "866-202-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAYNE LEE MD PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-579-3369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME93895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.