MEDICARE: DR. LEE N ANTON MD

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	208000000X	Pediatrics Physician	ME136833	FL
2	207R00000X	Internal Medicine Physician	ME136833	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1622768	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1942202478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE N ANTON MD

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE FL 2
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	18699 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-7388
Country	:	US
Telephone Number	:	941-429-3416
Fax Number	:	941-429-3430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	06/22/2023

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