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NPI Code Detail

MEDICARE: FSQ THE PALMS AT FORT MYERS LLC

MEDICARE: FSQ THE PALMS AT FORT MYERS LLC
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
1310400000XAssisted Living FacilityAL7269FL

General Provider Information

NPI Number : 1831134535
Entity Type Code : Organization
Provider Name (Legal Business Name) : FSQ THE PALMS AT FORT MYERS LLC
Provider Business Mailing Address
First Line : 255 WASHINGTON ST STE 270
Second Line :
City : NEWTON
State : MA
Zip : 02458-1634
Country : US
Telephone Number : 617-796-8387
Fax Number : 617-796-8385
Provider Business Practice Location Address
First Line : 2674 WINKLER AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9361
Country : US
Telephone Number : 239-275-7800
Fax Number : 239-275-2023
Authorized Official
Title or Position : PRESIDENT & CHIEF EXECUTIVE OFFICER
Name : JEFFREY C. LEER
Credential :
Telephone Number : 617-796-8387
Provider Enumeration Date : 06/17/2006
Last Update Date : 08/11/2022

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Directions to “FSQ THE PALMS AT FORT MYERS LLC ” Practice Location

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