Provider Demographics
NPI:1750517454
Name:LEE, KAM POH (AP)
Entity type:Individual
Prefix:MR
First Name:KAM
Middle Name:POH
Last Name:LEE
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 EASTWEST PKWY
Mailing Address - Street 2:STE 5
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-6336
Mailing Address - Country:US
Mailing Address - Phone:904-215-6111
Mailing Address - Fax:
Practice Address - Street 1:1835 EASTWEST PKWY
Practice Address - Street 2:STE 5
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-6336
Practice Address - Country:US
Practice Address - Phone:904-215-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 578171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist