Provider Demographics
NPI:1457546988
Name:IM HOSPITALIST, PA
Entity Type:Organization
Organization Name:IM HOSPITALIST, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERILEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-303-2600
Mailing Address - Street 1:1530 LEE BLVD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-4893
Mailing Address - Country:US
Mailing Address - Phone:239-303-2600
Mailing Address - Fax:239-303-2604
Practice Address - Street 1:615 WILLIAMS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-7947
Practice Address - Country:US
Practice Address - Phone:239-303-2600
Practice Address - Fax:239-303-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty