MEDICARE: COUNTY OF LEE-OFFICE OF COUNTY COMM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416A0800X	Air Ambulance	3389	FL
2	3416L0300X	Land Ambulance
3	341600000X	Ambulance	3389	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00185611	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477663839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF LEE-OFFICE OF COUNTY COMM

Provider Business Mailing Address
First Line	:	PO BOX 198252
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-8252
Country	:	US
Telephone Number	:	239-533-3911
Fax Number	:	239-485-2626

Provider Business Practice Location Address
First Line	:	2000 MAIN ST
Second Line	:	STE 100
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5502
Country	:	US
Telephone Number	:	239-533-3911
Fax Number	:	239-485-2626

Authorized Official
Title or Position	:	DIRECTOR OF PUBLIC SAFETY
Name	:	BENJAMIN ABES
Credential	:
Telephone Number	:	239-533-3963

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	11/21/2024

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Directions to “COUNTY OF LEE-OFFICE OF COUNTY COMM ” Practice Location

Language	Start Address	Practice Location

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