Active NPI
Isaac Kyoungho Lee, DO
- Student in an Organized Health Care Education/Training Program
- Inverness, FL
National Provider Identifier
1801586276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 502 W Highland Blvd
Inverness, FL 34452-4720 - Phone
- (352) 446-6987
- NPI assigned
- May 10, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
502 W Highland Blvd
Inverness, FL 34452-4720
Mailing address
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Other practice location 1
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone (954) 786-6738
Other practice location 2
1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 786-6738
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914004150 | FL | Order and Referring Only - Other (Physician) | 6406210095 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711152000000",
"number": "1801586276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 S ANDREWS AVE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333162510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 W HIGHLAND BLVD",
"city": "INVERNESS",
"state": "FL",
"postal_code": "344524720",
"telephone_number": "352-446-6987"
}
],
"practiceLocations": [
{
"address_1": "201 E Sample Rd",
"address_purpose": "LOCATION",
"city": "Deerfield Beach",
"state": "FL",
"postal_code": "330643502",
"country_code": "US",
"telephone_number": "954-786-6738",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1600 S Andrews Ave",
"address_purpose": "LOCATION",
"city": "Fort Lauderdale",
"state": "FL",
"postal_code": "333162510",
"country_code": "US",
"telephone_number": "954-786-6738",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "ISAAC",
"middle_name": "KYOUNGHO",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-10",
"last_updated": "2024-03-23",
"certification_date": "2024-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inverness, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.