Individual provider Active NPI

Andrew Yeon Lee, DO

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1770088619
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS17478 Issued in FL
Practice address
2501 N Orange Ave Ste 235
Orlando, FL 32804-4659
Phone
(407) 845-8362
Fax
(407) 845-8363
NPI assigned
Mar 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS17478 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X UO6029 FL

Addresses

Primary practice location

2501 N Orange Ave Ste 235
Orlando, FL 32804-4659

Mailing address

841 Prudential Dr Ste 1130
Jacksonville, FL 32207-8331
Phone (904) 633-4199

Other practice location 1

841 Prudential Dr Ste 1130
Jacksonville, FL 32207-8331
Phone (904) 633-4199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210413000288 FL Practitioner - Pediatric Medicine 9739597774 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS17478FLMDPediatrics Physician
UO6029FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Pediatrics CurrentSince Jul 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince May 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince May 1, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

841 Prudential Dr
Ste 1130
Jacksonville, FL 32207
Phone (904) 633-4180

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 235
Orlando, FL 32804
Phone (407) 303-1967

2200 Fowler Grove Blvd
Ste 220
Winter Garden, FL 34787
Phone (407) 646-0042

1573 W Fairbanks Ave
Ste 300
Winter Park, FL 32789
Phone (407) 303-6729

Interoperability endpoints

  • Direct secure messaging: alee2912684@adventhealth.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1770088619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 1130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078331",
            "telephone_number": "904-633-4199",
            "fax_number": "904-633-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 235",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659",
            "telephone_number": "407-845-8362",
            "fax_number": "407-845-8363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "841 Prudential Dr Ste 1130",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078331",
            "country_code": "US",
            "telephone_number": "904-633-4199",
            "fax_number": "904-633-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREW",
        "middle_name": "YEON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS17478",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO6029",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.