Healthcare Provider Details

I. General information

NPI: 1285263780
Provider Name (Legal Business Name): LEE MEMORIAL HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9981 S HEALTHPARK DR
FORT MYERS FL
33908-3618
US

IV. Provider business mailing address

1815 CORAL CIR
NORTH FORT MYERS FL
33903-5000
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-5000
  • Fax:
Mailing address:
  • Phone: 239-691-6329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

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