| Lisa Bendetowicz, Lcsw, Llc | |
|
6840 International Center Blvd Fort Myers FL 33912-7161 | |
| (239) 985-1050 | |
| (239) 985-1060 |
| Full Name | Lisa Bendetowicz, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6840 International Center Blvd, Fort Myers, Florida |
| Authorized Official Name and Position | Lisa Bendetowicz (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2398503402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Bendetowicz, Lcsw, Llc 6840 International Center Blvd Fort Myers FL 33912-7161 Ph: (239) 850-3402 | Lisa Bendetowicz, Lcsw, Llc 6840 International Center Blvd Fort Myers FL 33912-7161 Ph: (239) 985-1050 |
| NPI Number | 1487200754 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 06/15/2020 |
| Certification Date | 06/15/2020 |
| Medicare PECOS PAC ID | 4688095904 |
|---|---|
| Medicare Enrollment ID | O20200522000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487200754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lisa R Bendetowicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245637214 PECOS PAC ID: 4385947613 Enrollment ID: I20160120002727 |
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