| Lee Memorial Health System | |
|
15901 Bass Rd Ste 100 Fort Myers FL 33908-3838 | |
| (239) 343-6100 | |
| (239) 343-9925 |
| Full Name | Lee Memorial Health System |
|---|---|
| Speciality | Clinic/Center |
| Location | 15901 Bass Rd Ste 100, Fort Myers, Florida |
| Authorized Official Name and Position | Joseph Albert Niebergall (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2394241446 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Memorial Health System Po Box 2147 Fort Myers FL 33902-2147 Ph: (239) 424-1500 | Lee Memorial Health System 15901 Bass Rd Ste 100 Fort Myers FL 33908-3838 Ph: (239) 343-6100 |
| NPI Number | 1912610338 |
|---|---|
| Provider Enumeration Date | 12/30/2022 |
| Last Update Date | 12/30/2022 |
| Medicare PECOS PAC ID | 8729996608 |
|---|---|
| Medicare Enrollment ID | O20230412002635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912610338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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