Provider Demographics
NPI:1720416548
Name:LEE COUNTY MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:LEE COUNTY MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TOUHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-226-0910
Mailing Address - Street 1:40 BARKLEY CIR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4518
Mailing Address - Country:US
Mailing Address - Phone:239-226-0910
Mailing Address - Fax:239-226-0912
Practice Address - Street 1:40 BARKLEY CIR
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-4518
Practice Address - Country:US
Practice Address - Phone:239-226-0910
Practice Address - Fax:239-226-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMC1539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty