| Lee Memorial Health System | |
|
22655 Bayshore Rd Ste 120 Port Charlotte FL 33980-2005 | |
| (239) 343-9888 | |
| (239) 343-4266 |
| Full Name | Lee Memorial Health System |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 22655 Bayshore Rd Ste 120, Port Charlotte, Florida |
| Authorized Official Name and Position | Vivian M Rodriguez (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2394241452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Memorial Health System Po Box 2147 Fort Myers FL 33902-2147 Ph: (239) 343-9888 | Lee Memorial Health System 22655 Bayshore Rd Ste 120 Port Charlotte FL 33980-2005 Ph: (239) 343-9888 |
| NPI Number | 1255171765 |
|---|---|
| Provider Enumeration Date | 05/31/2024 |
| Last Update Date | 05/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255171765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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