Organization
PRIME HEALTHCARE SERVICES - LEHIGH PHYSICIAN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
(909) 235-4307
Entity
Organization
Contact information
Practice address
1530 LEE BLVD STE 1100, LEHIGH ACRES, FL 33936-4887
(239) 368-0241
(239) 368-1224
Mailing address
1530 LEE BLVD STE 1100, LEHIGH ACRES, FL 33936-4887
(239) 368-0241
(239) 368-1224
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
213E00000X
Podiatrist
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019954500
—
FL
01
—
AJ2FT
BCBS
FL
Enumeration date
01/28/2016
Last updated
09/05/2023
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