MEDICARE: LEE MEMORIAL HEALTH SYSTEM

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	3336S0011X	Specialty Pharmacy
2	282N00000X	General Acute Care Hospital		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	523	OTHER	FL	BLUE CROSS PROVIDER NUMB
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558302570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE MEMORIAL HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	PO BOX 150107
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33915-0107
Country	:	US
Telephone Number	:	239-424-1503
Fax Number	:	239-424-1599

Provider Business Practice Location Address
First Line	:	2776 CLEVELAND AVE
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33901-5864
Country	:	US
Telephone Number	:	239-424-1503
Fax Number	:	239-424-1599

Authorized Official
Title or Position	:	CHEIF FINANCIAL OFFICER
Name	:	BENJAMIN SPENCE
Credential	:
Telephone Number	:	239-343-6012

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	10/18/2018

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Directions to “LEE MEMORIAL HEALTH SYSTEM ” Practice Location

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