Provider Demographics
NPI:1174382436
Name:LEE, RICKY (DO)
Entity type:Individual
Prefix:
First Name:RICKY
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HCA FLORIDA ST. LUCIE HOSPITAL
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952
Mailing Address - Country:US
Mailing Address - Phone:772-335-4000
Mailing Address - Fax:
Practice Address - Street 1:HCA FLORIDA ST. LUCIE HOSPITAL
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION
Practice Address - City:PORT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952
Practice Address - Country:US
Practice Address - Phone:772-335-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program