Provider Demographics
NPI:1477663839
Name:COUNTY OF LEE-OFFICE OF COUNTY COMM
Entity Type:Organization
Organization Name:COUNTY OF LEE-OFFICE OF COUNTY COMM
Other - Org Name:LEE COUNTY EMERGENCY MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PUBLIC SAFETY
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-533-3963
Mailing Address - Street 1:PO BOX 198252
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8252
Mailing Address - Country:US
Mailing Address - Phone:239-533-3911
Mailing Address - Fax:239-485-2626
Practice Address - Street 1:2000 MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5502
Practice Address - Country:US
Practice Address - Phone:239-533-3911
Practice Address - Fax:239-485-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3389341600000X, 3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00185611OtherRAILROAD MEDICARE
FL420009800Medicaid
FL088022100Medicaid
FL420009800Medicaid