Provider Demographics
NPI:1295112985
Name:LEE FAMILY WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:LEE FAMILY WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-400-4856
Mailing Address - Street 1:PO BOX 152491
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33915-2491
Mailing Address - Country:US
Mailing Address - Phone:239-400-4856
Mailing Address - Fax:239-791-5526
Practice Address - Street 1:530 SE 16TH PL
Practice Address - Street 2:SUITE B
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1656
Practice Address - Country:US
Practice Address - Phone:239-400-4856
Practice Address - Fax:239-791-5526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTIN