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General NPI Number Information
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NPI Number | 1932214848
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Entity Type | Organization
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Legal Business Name | DR. LEE R. LIGHT M.D.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 850 CENTRAL AVE STE 301
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City | NAPLES
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State | FL
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Zip | 34102-6021
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Country | US
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Telephone | 239-262-1833
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Fax | 239-262-3097
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Provider Business Mailing Address
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Address Line | 850 CENTRAL AVE STE 301
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City | NAPLES
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State | FL
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Zip | 34102-6021
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Country | US
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Telephone | 239-262-1833
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Fax | 239-262-3097
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. LEE RAYMOND LIGHT
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Credential | M.D.
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Telephone | 239-262-1833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0020345
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License Number State | FL
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