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NPI Code Detail

MEDICARE: LEE MEMORIAL HOME HEALTH INC

MEDICARE: LEE MEMORIAL HOME HEALTH INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyHHA20643096FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21013546OTHERFLACM - PROVIDER NUMBER

General Provider Information

NPI Number : 1689672065
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEE MEMORIAL HOME HEALTH INC
Provider Business Mailing Address
First Line : 12771 WESTLINKS DR
Second Line : SUITE 9
City : FORT MYERS
State : FL
Zip : 33913-8074
Country : US
Telephone Number : 239-225-7700
Fax Number : 239-225-7699
Provider Business Practice Location Address
First Line : 12801 WESTLINKS DR STE 101
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8001
Country : US
Telephone Number : 239-225-7700
Fax Number : 239-343-4103
Authorized Official
Title or Position : SYSTEM DIRECTOR/ADMINISTRATOR HOME
Name : JONATHAN HOLLANDAR
Credential : RN, MBA
Telephone Number : 239-225-7688
Provider Enumeration Date : 07/11/2005
Last Update Date : 05/23/2024

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1922585066 — MELISA MARIA RODRIGUEZ ARNP
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Directions to “LEE MEMORIAL HOME HEALTH INC ” Practice Location

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