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Organization

LEE MEMORIAL HEALTH SYSTEM

Active
Other names
LCH- CARDIOLOGY @ SANCTUARY
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH NIEBERGALL (CREDENTIALING SPECIALIST)
(239) 424-1446
Entity
Organization

Contact information

Practice address
8960 COLONIAL CENTER DR STE 302, FORT MYERS, FL 33905-7810
(239) 343-9700
(239) 343-9699
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9700
(239) 343-9699

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
08/05/2022
Last updated
08/05/2022
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