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NPI Code Detail

MEDICARE: PROMISE HOSPITAL OF LEE, INC.

MEDICARE: PROMISE HOSPITAL OF LEE, INC.
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
1282E00000XLong Term Care Hospital

General Provider Information

NPI Number : 1548680036
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROMISE HOSPITAL OF LEE, INC.
Provider Business Mailing Address
First Line : 999 YAMATO RD FL 3
Second Line :
City : BOCA RATON
State : FL
Zip : 33431-4477
Country : US
Telephone Number : 561-869-3100
Fax Number : 800-645-1942
Provider Business Practice Location Address
First Line : 3050 CHAMPION RING RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5599
Country : US
Telephone Number : 561-869-3100
Fax Number : 800-645-1942
Authorized Official
Title or Position : CFO
Name : MR. JAMES HOPWOOD
Credential :
Telephone Number : 561-869-3100
Provider Enumeration Date : 04/23/2014
Last Update Date : 04/10/2018

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