Organization
LEE COUNTY TRAUMA SERVICES DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ANTONUCCI (PRESIDENT,CEO)
(239) 343-6537
Entity
Organization
Contact information
Practice address
13685 DOCTORS WAY STE 100, FORT MYERS, FL 33912-4337
(239) 343-1612
(239) 343-4229
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-1500
(239) 424-1423
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268529900
—
FL
Enumeration date
01/04/2007
Last updated
11/06/2023
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