Healthcare Provider Details

I. General information

NPI: 1033080676
Provider Name (Legal Business Name): LAUREN FOX APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8981 COLONIAL CENTER DR
FORT MYERS FL
33905-7816
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 239-938-0800
  • Fax: 866-420-0122
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11042203
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: