=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710864871
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF LEE OFFICE OF SHERIFF
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2025
-----------------------------------------------------
Last Update Date | 08/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2501 ORTIZ AVE
-----------------------------------------------------
City | FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33905-7804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-477-1000
-----------------------------------------------------
Fax | 239-477-1786
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14750 SIX MILE CYPRESS PKWY
-----------------------------------------------------
City | FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33912-4406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-477-1000
-----------------------------------------------------
Fax | 239-477-1786
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH SERVICES DIRECTOR / CORRECTI
-----------------------------------------------------
Name | MS. NICHOLE LEE GREINER
-----------------------------------------------------
Credential | RN, MSN, CCHP
-----------------------------------------------------
Telephone | 239-477-1751
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2400X
-----------------------------------------------------
Taxonomy Name | Prison Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------