Organization
LEE MEMORIAL HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN K. WEIST (CHIEF FINANCIAL OFFICER)
(239) 772-6542
Entity
Organization
Contact information
Practice address
2780 CLEVELAND AVE, SUITE 705, FORT MYERS, FL 33901-5858
(239) 334-5244
Mailing address
P.O. BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-1400
(239) 424-1421
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200542
AVMED
FL
05
—
268592200
—
FL
01
—
39054
BLUE CROSS BLUE SHIELD
FL
01
—
95986
AMERIGROUP
FL
Enumeration date
09/07/2006
Last updated
06/21/2018
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