Healthcare Provider Details

I. General information

NPI: 1295112985
Provider Name (Legal Business Name): LEE FAMILY WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SE 16TH PL SUITE B
CAPE CORAL FL
33990-1656
US

IV. Provider business mailing address

PO BOX 152491
CAPE CORAL FL
33915-2491
US

V. Phone/Fax

Practice location:
  • Phone: 239-400-4856
  • Fax: 239-791-5526
Mailing address:
  • Phone: 239-400-4856
  • Fax: 239-791-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS APONTE
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 239-400-4856