| Leesang Services LLC | |
|
1317 Edgewater Dr # 2761 Orlando FL 32804-6350 | |
| (561) 598-9609 | |
| Not Available |
| Full Name | Leesang Services LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1317 Edgewater Dr # 2761, Orlando, Florida |
| Authorized Official Name and Position | Lasandra Lee (OWNER) |
| Authorized Official Contact | 5615989609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leesang Services LLC 1317 Edgewater Dr # 2761 Orlando FL 32804-6350 Ph: (561) 598-9609 | Leesang Services LLC 1317 Edgewater Dr # 2761 Orlando FL 32804-6350 Ph: (561) 598-9609 |
| NPI Number | 1801604707 |
|---|---|
| Provider Enumeration Date | 12/23/2024 |
| Last Update Date | 12/23/2024 |
| Certification Date | 12/23/2024 |
| Medicare PECOS PAC ID | 4981124328 |
|---|---|
| Medicare Enrollment ID | O20250228000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801604707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | () | Secondary |
| Provider Name | Lasandra Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992447452 PECOS PAC ID: 9133652738 Enrollment ID: I20241104000871 |
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