Organization
LEE MEMORIAL HEALTH SYSTEM
Active
Other names
LCH-Peds Cape Coral
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH NIEBERGALL (CREDENTIALING SPECIALIST)
(239) 424-1446
Entity
Organization
Contact information
Practice address
650 DEL PRADO BLVD S STE 107, CAPE CORAL, FL 33990-5629
(239) 343-9888
(239) 424-4091
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-1449
(239) 424-1423
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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