LEE MEMORIAL HEALTH SYSTEM (NPI# 1407472186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407472186 |
| Entity Type | Organization |
| Organization Name | LEE MEMORIAL HEALTH SYSTEM |
| Practice Address |
12550 New Brittany Blvd Ste 100 Fort Myers FL 33907-3655 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393439180 |
| Practice Fax Number | 2393439190 |
| Mailing Telephone | 2394241449 |
| Mailing Fax Number | 2394241423 |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |
| Authorized Official Name | JOSEPH NIEBERGALL (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 2394241446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LCH-BEHAVIORAL HEALTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425028 | Lee Memorial Health System | Clinic/Center | 2525 Harbor Blvd Ste 204, Port Charlotte, FL 33952-5342 | 2020-04-09 |
| 1164051405 | Lee Memorial Health System | Clinic/Center | 2484 Caring Way Unit F, Port Charlotte, FL 33952-5306 | 2020-04-08 |
| 1114409141 | Lee Memorial Health System | Skilled Nursing Facility | 13960 Plantation Rd, Fort Myers, FL 33912-4303 | 2018-09-06 |
| 1124513593 | Lee Memorial Health System | Pharmacy | 23450 Via Coconut Point, Estero, FL 34135 | 2018-06-27 |
| 1790153062 | Lee Memorial Health System | Pharmacy | 3361 Pine Ridge Rd, Suite 100, Naples, FL 34109 | 2015-09-03 |
| 1801196266 | Lee Memorial Health System | Pharmacy | 11220 Metro Pkwy Ste 31, Fort Myers, FL 33966-1291 | 2010-11-01 |
| 1942826623 | Lee Memorial Health System | Clinic/Center | 12550 New Brittany Blvd Ste 201, Fort Myers, FL 33907-3655 | 2020-06-18 |
| 1285263780 | Lee Memorial Health System | Pharmacy | 9981 S Healthpark Dr, Fort Myers, FL 33908-3618 | 2020-04-06 |
| 1730718735 | Lee Memorial Health System | Pharmacy | 13681 Doctors Way, Fort Myers, FL 33912-4300 | 2020-04-02 |
| 1104455187 | Lee Memorial Health System | Pharmacy | 2776 Cleveland Ave, Fort Myers, FL 33901-5864 | 2020-04-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEE MEMORIAL HEALTH SYSTEM | 2776 Cleveland Ave, Fort Myers, FL 33901-5864 |
| System for Award Management (SAM) Entities | LEE MEMORIAL HEALTH SYSTEM FOUNDATION | 16451 Healthpark Commons Dr # 2, Fort Myers, FL 33908-9501 |
| System for Award Management (SAM) Entities | LEE MEMORIAL HEALTH SYSTEM FOUNDATION, INC. | 2776 Cleveland Ave, Fort Myers, FL 33901-5864 |
| Street Address |
12550 NEW BRITTANY BLVD STE 100 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528122660 | Carron C Cherrie | Registered Nurse | 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907 | 2006-12-21 |
| 1043791866 | John J Matthews | Social Worker | 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907 | 2018-08-29 |
| 1497259394 | Dina Esther Grodson | Registered Nurse | 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907-3655 | 2018-03-23 |
| 1184080509 | Eric Raab | Psychiatry & Neurology | 12550 New Brittany Blvd Ste 100, Fort Myers, FL 33907 | 2016-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356853154 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 1926 Victoria Ave, Fort Myers, FL 33901-3414 | 2017-11-02 |
| 1891010393 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 13195 Metro Parkway, Suites 6-9, Fort Myers, FL 33966-0000 | 2010-03-29 |
| 1942826623 | Lee Memorial Health System | Clinic/Center | 12550 New Brittany Blvd Ste 201, Fort Myers, FL 33907-3655 | 2020-06-18 |
| 1013559343 | Lee Memorial Health System | Clinic/Center | 4751 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2019-10-08 |
| 1538607031 | Lee Memorial Health System | Clinic/Center | 16271 Bass Rd, Fort Myers, FL 33908-3616 | 2017-02-03 |
| 1881131423 | Lee Memorial Health System | Clinic/Center | 4040 Palm Beach Blvd, Suite F, Fort Myers, FL 33916-3470 | 2017-01-20 |
| 1871946368 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 10501 Fgcu Blvd S, Fort Myers, FL 33965-6502 | 2016-07-20 |
| 1891142238 | Lee Memorial Health System | Clinic/Center | 3511 Dr Martin Luther King Blvd, Fort Myers, FL 33916-4651 | 2016-05-16 |
| 1366748402 | Family Health Centers of Southwest Florida, Inc. | Clinic/Center | 3600 Broadway, Suite A, Fort Myers, FL 33901-8002 | 2011-02-08 |
| 1669634903 | Family Health Centers of Southwest Florida Inc | Clinic/Center | 4040 Palm Beach Blvd, Fort Myers, FL 33916-3470 | 2008-06-27 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
Please comment or provide details below to improve the information on LEE MEMORIAL HEALTH SYSTEM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.