Lee Memorial Health System
Clinic/Center, Federally Qualified Health Center (FQHC) in Port Charlotte, FL. Organization (NPI-2).
NPI number1164051405
StatusActive
Last updated in NPPESApr 8, 2020
Details
- NPI
- 1164051405
- Entity type
- Organization (NPI-2)
- Legal business name
- Lee Memorial Health System
- Organization subpart
- No
- Enumeration date
- Apr 8, 2020
- Certification date
- Apr 8, 2020
- Last updated
- Apr 8, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- Lch-Peds PC#1 (Doing Business As)
Practice location
2484 Caring Way Unit FPort Charlotte, FL 33952-5306
Phone 941-625-1999 · Fax 941-625-4600
Mailing address
Po Box 2147Fort Myers, FL 33902-2147
Phone 941-625-1999 · Fax 941-625-4600
Authorized official
Joseph Niebergall
Credentialing Specialist
2394241446
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All 8 Federally Qualified Health Center (FQHC) providers in Port Charlotte · All 2,518 providers in Port Charlotte
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