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NPI Code Detail

MEDICARE: LANDMARK HOSPITAL OF SOUTHWEST FLORIDA, LLC

MEDICARE: LANDMARK HOSPITAL OF SOUTHWEST FLORIDA, 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
1282E00000XLong Term Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932595659
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANDMARK HOSPITAL OF SOUTHWEST FLORIDA, LLC
Provider Business Mailing Address
First Line : PO BOX 267
Second Line :
City : JACKSON
State : MO
Zip : 63755-0267
Country : US
Telephone Number : 573-331-8412
Fax Number :
Provider Business Practice Location Address
First Line : 1500 LEE BLVD FL 3
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-4835
Country : US
Telephone Number : 573-331-8412
Fax Number :
Authorized Official
Title or Position : CFO
Name : TRACY LYNNE BOLLINGER
Credential : CPA
Telephone Number : 573-450-2530
Provider Enumeration Date : 04/09/2015
Last Update Date : 03/09/2026

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Directions to “LANDMARK HOSPITAL OF SOUTHWEST FLORIDA, LLC ” Practice Location

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