Healthcare Provider Details

I. General information

NPI: 1922790641
Provider Name (Legal Business Name): LEE MEMORIAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 HOSPITAL DR STE 120
ESTERO FL
34135-8111
US

IV. Provider business mailing address

8350 HOSPITAL DR STE 120
ESTERO FL
34135-8111
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-7277
  • Fax: 239-343-5829
Mailing address:
  • Phone: 239-343-7277
  • Fax: 239-343-5829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN SPENCE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 239-343-6014