Healthcare Provider Details

I. General information

NPI: 1114620705
Provider Name (Legal Business Name): IGOR LEKIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SANTA BARBARA BLVD STE 102
CAPE CORAL FL
33991-2038
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-1900
  • Fax: 239-424-1908
Mailing address:
  • Phone: 239-424-1900
  • Fax: 239-343-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME174440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: