Organization
LEE MEMORIAL HEALTH SYSTEM
Active
Other names
LCH- Family Practice Clayton Court, LCH FM Clayton Crt
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH NIEBERGALL (CREDENTIALING SPECIALIST)
(239) 424-1446
Entity
Organization
Contact information
Practice address
5225 CLAYTON CT, FORT MYERS, FL 33907-2117
(239) 343-8240
(239) 468-7906
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9240
(239) 468-7906
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
09/14/2023
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